Andrea Backstrom

NPI #1386063121 in Blaine, Minnesota

Provider Information

NPI Number: 1386063121
Entity Type: Individual
Name: Andrea Backstrom
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Apr 9, 2014
Last Updated: Apr 9, 2014

Practice Location

Address: 865 124TH AVE NE
City: Blaine
State: Minnesota
ZIP Code: 55434-3169
Phone: (612) 750-6235

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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