Individual
MR. TIBLI OLANDRUS DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MANAGER
Contact information
Practice address
7400 122ND AVE N, CHAMPLIN, MN 55316-2127
(612) 865-6220
Mailing address
7400 122ND AVE N, CHAMPLIN, MN 55316-2127
(612) 865-6220
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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