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Individual

PAMELA BLOEDEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
8100 W 78TH ST, EDINA, MN 55439-2516
(952) 914-8065
(952) 914-8066
Mailing address
8100 W 78TH ST STE 205, EDINA, MN 55439-2560
(952) 914-8065
(952) 914-8066

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5173
MN
2251X0800X
Orthopedic Physical Therapist
5173
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6405876
MEDICA INDIV PROV ID
MN
01
77G03BL
BC INDIV PROV ID
MN
Enumeration date
04/11/2006
Last updated
04/02/2020
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