Healthcare Provider Details

I. General information

NPI: 1659024990
Provider Name (Legal Business Name): MEGAN ELIZABETH ZADOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 W 106TH ST
BLOOMINGTON MN
55431-4152
US

IV. Provider business mailing address

1350 W 106TH ST
BLOOMINGTON MN
55431-4152
US

V. Phone/Fax

Practice location:
  • Phone: 952-681-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number106784
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: