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General NPI Number Information
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NPI Number | 1013804988
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Entity Type | Individual
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Provider Name | ADAM BLASCHKO DPT
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Gender | Male
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 300 LAKE DR E
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City | CHANHASSEN
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State | MN
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Zip | 55317-9302
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Country | US
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Telephone | 952-993-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 8872 COVE POINTE RD
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-2429
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Country | US
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Telephone | 952-215-2420
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13976
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License Number State | MN
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