Individual ProviderRalph James ThrockmortonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address8290 University Ave NE, 300, Fridley, MN 55432-1847(763) 784-2340PECOS EnrollmentBased on the most recent information from CMS, provider Ralph James Throckmorton does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1588631899Provider TypeIndividualFull NameThrockmorton, Ralph JamesTitleMr.CredentialPTGenderMaleEnumeration Date3/6/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address8290 University Ave NE, 300, Fridley, MN 55432-1847Phone(763) 784-2340Fax(763) 786-1046Mailing LocationMailing Address9138 Bataan St NE, Blaine, MN 55449-5615Phone(763) 784-2340Fax(763) 786-1046Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense2614Minnesota