Individual
NICOLE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3912 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416-4709
(952) 835-4512
(888) 425-0398
Mailing address
7825 3RD ST N STE 105, OAKDALE, MN 55128-5444
(952) 835-4512
(888) 425-0398
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10211
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071898
OPTUM (UNITED HEALTH CARE) PROVIDER ID
MN
Enumeration date
02/29/2016
Last updated
07/19/2021
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