Individual
PAUL ROBERT HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2090 WOODWINDS DR., WOODBURY, MN 55125
(651) 968-5801
(651) 968-5899
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
(651) 968-5042
(651) 968-5904
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
4705
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401144
SELECT CARE
MN
01
—
P00019022
RAILROAD MEDICARE
MN
Enumeration date
03/16/2006
Last updated
07/01/2015
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