MEDICARE: GLORIA WAHLROOS

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	13401	MN

General Provider Information

NPI Number	:	1699269613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA WAHLROOS

Provider Business Mailing Address
First Line	:	1866 YORKSHIRE AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2404
Country	:	US
Telephone Number	:	651-497-6694
Fax Number	:

Provider Business Practice Location Address
First Line	:	1866 YORKSHIRE AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2404
Country	:	US
Telephone Number	:	651-497-6694
Fax Number	:

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

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	07/23/2025

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Directions to “ GLORIA WAHLROOS ” Practice Location

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