Richard Bom PT

NPI 1689789554 - Physical Therapist - 225100000X

NPI Details
NPI 1689789554
Gender Male
Enumeration Date 08/20/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
775 PRAIRIE CENTER DR
#250
EDEN PRAIRIE MN, 55344-7314, US
Phone (952) 944-5314
Fax
Business Location
19540 VINE RIDGE RD
EXCELSIOR MN, 55331-9118, US
Phone
Fax
Toxanomy
Taxonomy Code 225100000X
License State Minnesota
License Number 2704
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According to our database, Richard Bom PT NPI is 1689789554, taxonomy code is 225100000X and license number is 2704, license state is located at Minnesota. Richard Bom PT physically located at 775 Prairie Center Dr, Eden Prairie MN, 55344-7314. NPI Number Richard Bom PT has the Individual type.

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1689789554 NPI number is provided on an as is basis without warranty of any kind. 1689789554 is maintained by the National Plan & Provider Enumeration System. The contents of Richard Bom PT are for informational purposes only.