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Individual

LUCAS BLANCHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3801 HART BLVD, COLUMBIA HEIGHTS, MN 55421-4106
(612) 364-1901
Mailing address
10653 WAYZATA BLVD STE 200, MINNETONKA, MN 55305-1543

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11796
MN

Other

Enumeration date
05/24/2021
Last updated
05/24/2021
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