Provider Demographics
NPI:1285234922
Name:DALDORPH, LUCY JOAN TOMPSON (DPT)
Entity type:Individual
Prefix:DR
First Name:LUCY
Middle Name:JOAN TOMPSON
Last Name:DALDORPH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 LYNDALE AVE S APT 511
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4670
Mailing Address - Country:US
Mailing Address - Phone:785-218-7138
Mailing Address - Fax:
Practice Address - Street 1:1401 E 100TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-2615
Practice Address - Country:US
Practice Address - Phone:785-218-7138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11602225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist