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General NPI Number Information
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NPI Number | 1467331900
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Entity Type | Individual
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Provider Name | ABIGAIL PATOKA DPT
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Gender | Female
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 215 RADIO DR STE 100
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City | WOODBURY
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State | MN
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Zip | 55125-5817
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Country | US
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Telephone | 612-596-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 1579 COUNTY ROAD D E UNIT C
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City | MAPLEWOOD
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State | MN
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Zip | 55109-5340
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14097
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License Number State | MN
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