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General NPI Number Information
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NPI Number | 1235793837
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Entity Type | Individual
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Provider Name | BRITTANY BLOMQUIST
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Gender | Female
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 04/06/2020
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Provider Practice Location Address
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Address Line | 35 STATE AVE
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City | FARIBAULT
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State | MN
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Zip | 55021-6368
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Country | US
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Telephone | 507-497-3790
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Fax |
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Provider Business Mailing Address
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Address Line | 16223 TERRACEWOOD DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55346-2425
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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