Individual
ANNEKA MARIE BOOMSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
9645 GROVE CIR N STE 100, MAPLE GROVE, MN 55369-2682
(763) 302-4114
(763) 287-2303
Mailing address
4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4215
(763) 588-0661
(763) 282-2303
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13797
MN
225100000X
Physical Therapist
14943
TN
225100000X
Physical Therapist
5501302474
MI
225100000X
Physical Therapist
P22131
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501302474
STATE LICENSE
MI
01
—
P22131
NC PT LICENSE
NC
Enumeration date
02/03/2023
Last updated
04/24/2026
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