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NPI Code Detail

MEDICARE: DR. LUCY JOAN TOMPSON DALDORPH DPT

MEDICARE: DR. LUCY JOAN TOMPSON DALDORPH DPT
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
1225100000XPhysical Therapist11602MN

General Provider Information

NPI Number : 1285234922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUCY JOAN TOMPSON DALDORPH DPT
Provider Business Mailing Address
First Line : 2833 LYNDALE AVE S APT 511
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-4670
Country : US
Telephone Number : 785-218-7138
Fax Number :
Provider Business Practice Location Address
First Line : 1401 E 100TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-2615
Country : US
Telephone Number : 785-218-7138
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2020
Last Update Date : 10/30/2020

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