Individual
BLAKE DEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3050 CENTRE POINTE DR STE 200, ROSEVILLE, MN 55113-1179
(888) 974-6636
Mailing address
7414 W 22ND ST APT 302, SAINT LOUIS PARK, MN 55426-2641
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
MN
Other
Enumeration date
06/12/2013
Last updated
09/10/2014
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