Individual
MR. NICKLAUS ELLIF BIEDERWOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
11209 N TATUM BLVD, B-120, PHOENIX, AZ 85028-3091
(602) 795-8441
(602) 795-8447
Mailing address
PO BOX 269084, OKLAHOMA CITY, OK 73126-9084
(623) 398-8072
(623) 398-8235
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
6704
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
908347
—
AZ
Enumeration date
11/22/2006
Last updated
11/04/2015
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