Healthcare Provider Details

I. General information

NPI: 1861322034
Provider Name (Legal Business Name): CARLA TOCKO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14610 GARRETT AVE
APPLE VALLEY MN
55124-8498
US

IV. Provider business mailing address

19820 ORR AVE
HASTINGS MN
55033-8811
US

V. Phone/Fax

Practice location:
  • Phone: 952-236-2570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number6253
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: