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NPI Code Detail

MEDICARE: ANNE ADIX PT

MEDICARE: ANNE ADIX PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist5938MN
2225100000XPhysical Therapist5938MN

General Provider Information

NPI Number : 1588755391
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE ADIX PT
Provider Business Mailing Address
First Line : 8170 33RD AVE S # MS 21110Q
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-4516
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12217 CHAMPLIN DR
Second Line :
City : CHAMPLIN
State : MN
Zip : 55316-1930
Country : US
Telephone Number : 763-323-1492
Fax Number : 763-422-1657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 03/09/2021

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Directions to “ ANNE ADIX PT” Practice Location

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