Provider Demographics
NPI:1376022384
Name:KASPER, JOSHUA TIMOTHY (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:TIMOTHY
Last Name:KASPER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7060 VALLEY CREEK PLZ STE 121
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2269
Mailing Address - Country:US
Mailing Address - Phone:651-735-8646
Mailing Address - Fax:
Practice Address - Street 1:7060 VALLEY CREEK PLZ STE 121
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2269
Practice Address - Country:US
Practice Address - Phone:651-735-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11272225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist