Individual
ERIC DILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
640 JACKSON ST, INPATIENT REHAB UNIT, ST PAUL, MN 55101
(651) 254-3456
Mailing address
12097 GANTRY CT, APPLE VALLEY, MN 55124-6200
(612) 357-6359
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2167
MN
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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