Tyler J Blong, DPT
Physical Therapist in Brainerd, MN. Individual provider (NPI-1).
NPI number1104383785
StatusActive
Last updated in NPPESMar 1, 2019
Details
- NPI
- 1104383785
- Entity type
- Individual (NPI-1)
- Name
- Tyler J Blong
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 1, 2019
- Last updated
- Mar 1, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Practice location
2016 S 6th StBrainerd, MN 56401-4529
Phone 218-828-7375
Mailing address
1702 University Dr SFargo, ND 58103-4940
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