Individual
RICHARD CLARK NIESSEN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.P.
Contact information
Practice address
2025 EAST RIVER PARK WAY, SHRINERS HOSPITALS FOR CHILDREN TWIN CITIES, MPLS, MN 55414-3604
(612) 596-6100
(612) 330-5954
Mailing address
2025 EAST RIVER PARK WAY, SHRINERS HOSPITALS FOR CHILDREN TWIN CITIES, MPLS, MN 55414-3604
(612) 596-6100
(612) 330-5954
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
01/12/2010
Last updated
01/12/2010
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