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1386215648
ADAM THACKER
EDEN PRAIRIE, MN
NPI
1386215648
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MN 12320)
Enumeration Date
2021-07-08
Last Update Date
2021-07-08
Business Address
ADAM THACKER DPT
16550 W 78TH ST STE B
EDEN PRAIRIE, MN 55346-4316
Phone number: 952-873-7400
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Mailing Address
ADAM THACKER DPT
7872 CENTURY BLVD
CHANHASSEN, MN 55317-8005
Phone number: 952-873-7400
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