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Individual
DOMINIC THIELEN
Active
Individual
DOMINIC THIELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
083240
IA
225100000X
Physical Therapist
PT-4458
ID
Other
Enumeration date
06/13/2016
Last updated
12/16/2021
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