Organization
BLUE SKY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LORI HAGOOD PT (PHYSICAL THERAPIST)
(405) 642-9469
Entity
Organization
Contact information
Practice address
411 FRONT ST, BRAINERD, MN 56401-3516
(405) 642-9469
Mailing address
29320 COUNTY ROAD 26, BROWERVILLE, MN 56438-0000
(405) 642-9469
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
8645
MN
261QR0400X
Rehabilitation Clinic/Center
8645
MN
Other
Enumeration date
11/17/2014
Last updated
11/17/2014
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