Richard Bom, PT
Physical Therapist in Eden Prairie, MN. Individual provider (NPI-1).
NPI number1689789554
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1689789554
- Entity type
- Individual (NPI-1)
- Name
- Richard Bom
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 2704 | MN | Yes |
Practice location
775 Prairie Center Dr#250
Eden Prairie, MN 55344-7314
Phone 952-944-5314
Mailing address
19540 Vine Ridge RdExcelsior, MN 55331-9118
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All 90 Physical Therapist providers in Eden Prairie · All 2,103 providers in Eden Prairie
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