Individual
ASHLEA TECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 W 81ST ST STE 103, BLOOMINGTON, MN 55437-1111
(952) 924-0199
Mailing address
4801 W 81ST ST STE 103, BLOOMINGTON, MN 55437-1111
(952) 924-0199
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2654
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A2654
MN STATE LICENSE ID
MN
Enumeration date
03/08/2021
Last updated
03/08/2021
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