Individual
MRS. PEGGY M BLENKUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
25945 GATEWAY DR, ZIMMERMAN, MN 55398-5300
(763) 856-6930
(763) 856-6933
Mailing address
13133 170TH AVE SE, BECKER, MN 55308-8503
(763) 856-6420
(763) 856-6933
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4171
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4171
PHYSICAL THERAPIST LICENS
MN
Enumeration date
11/01/2006
Last updated
07/08/2007
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