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General NPI Number Information
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NPI Number | 1285367821
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Entity Type | Individual
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Provider Name | EILEEN SHEA LOESCH PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 3400 W 66TH ST STE 300
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City | EDINA
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State | MN
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Zip | 55435-2110
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Country | US
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Telephone | 763-780-0356
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Fax |
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Provider Business Mailing Address
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Address Line | 4218 WOODDALE AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-3243
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Country | US
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Telephone | 612-710-3590
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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 | 12717
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License Number State | MN
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