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Contact Information

ETHAN BLANKESPOOR, PT, DPT
3800 AMERICAN BLVD W # 200
BLOOMINGTON, MN55431-4420
 Phone: 952-831-8742
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for ETHAN BLANKESPOOR · (Male)

NPI Number 1992231732
Status Active
Credentials PT, DPT
Entity Individual
Enumeration date 05/11/2017
Last updated 03/05/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 11163
  • SD License # 1974
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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