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Individual

TIMOTHY DOUGLAS OLDENKAMP

Active
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Individual

TIMOTHY DOUGLAS OLDENKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
7086
MN
225100000X
Physical Therapist
Primary
7086
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030701011
PRIME WEST
MN
01
—
057H8OL
BLUE CROSSBLUE SHIELD
MN
01
—
122234
UCARE
MN
05
—
328542100
—
MN
01
—
6406167
MEDICA
MN
Enumeration date
04/11/2007
Last updated
04/02/2025
About Stedi
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