Individual
NICOLAAS VAN DIJK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
400 WABASHA ST N STE 260, SAINT PAUL, MN 55102-1147
(952) 831-8742
Mailing address
400 WABASHA ST N STE 260, SAINT PAUL, MN 55102-1147
(952) 831-8742
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12435
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12435
MINNESOTA BOARD OF PHYSICAL THERAPY
MN
Enumeration date
08/31/2021
Last updated
08/31/2021
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