Individual
ROBERT HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
301 N BROADWAY, PELICAN RAPIDS, MN 56572-4113
(218) 863-2000
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 863-2000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102343
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356627491
—
MN
Enumeration date
11/02/2011
Last updated
03/12/2014
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