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1053625434

NPI Code Detail

MEDICARE: JOHN A CORBO PT

MEDICARE: JOHN A CORBO PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	8514	MN

General Provider Information

NPI Number	:	1053625434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN A CORBO PT

Provider Business Mailing Address
First Line	:	3500 AMERICAN BLVD W STE 300
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55431-4442
Country	:	US
Telephone Number	:	952-512-5600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1398 LAKE ST S STE 100
Second Line	:
City	:	FOREST LAKE
State	:	MN
Zip	:	55025-2720
Country	:	US
Telephone Number	:	651-275-2700
Fax Number	:	651-309-0000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	06/01/2026

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Directions to “ JOHN A CORBO PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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