Organization
LOON STATE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW ECCLES DPT (OWNER)
(612) 805-2676
Entity
Organization
Contact information
Practice address
4420 DREW AVE S, MINNEAPOLIS, MN 55410-1337
(612) 405-8503
Mailing address
5800 12TH AVE S, MINNEAPOLIS, MN 55417-3239
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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