Individual
DYLAN SHIREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3700 FOSS RD, MINNEAPOLIS, MN 55421-4512
(612) 788-9673
Mailing address
927 24TH ST SE, ROCHESTER, MN 55904-2903
(507) 251-8117
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105537
MN
225X00000X
Occupational Therapist
12567
CA
Other
Enumeration date
11/20/2017
Last updated
11/20/2017
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