Individual
ADAM T THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1000 W 140TH ST UNIT 201, BURNSVILLE, MN 55337-4833
(952) 808-3000
Mailing address
3500 AMERICAN BLVD W STE 300, BLOOMINGTON, MN 55431-4442
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12320
MN
Other
Enumeration date
07/08/2021
Last updated
09/04/2025
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