Provider Demographics
NPI:1669365839
Name:TREADWELL, DPT LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:TREADWELL, DPT LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TREADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:901-626-8996
Mailing Address - Street 1:1125 S 2ND ST APT 516
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-2133
Mailing Address - Country:US
Mailing Address - Phone:901-626-8996
Mailing Address - Fax:
Practice Address - Street 1:2500 HIGHWAY 88 STE 214
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-4228
Practice Address - Country:US
Practice Address - Phone:901-626-8996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy