Individual
ANDREA BACKSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
865 124TH AVE NE, BLAINE, MN 55434-3169
(612) 750-6235
Mailing address
865 124TH AVE NE, BLAINE, MN 55434-3169
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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