Todd Blowers

Individual provider Active NPI Speech-Language Pathologist · Baxter, MN

NPI 1003000340 · NPPES record last updated Aug 29, 2007

Key facts

NPI
1003000340
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
ASHA01114077 (MI)
Practice address
13795 Kenwood Dr
Baxter, MN 56425-8504
Phone
(435) 313-0686
NPI assigned
Aug 29, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
ASHA01114077MIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X ASHA01114077 MI Yes

Addresses

Primary practice location

13795 Kenwood Dr
Baxter, MN 56425-8504

Mailing address

13795 Kenwood Dr
Baxter, MN 56425-8504
Phone (435) 313-0686

Other identifiers

IdentifierTypeStateIssuer
01114077OtherMIASHA #

Other providers in Baxter, MN

All providers in Baxter, MN · Speech-Language Pathologist in Minnesota

Sources for this page

Verify at the official NPI Registry.