Individual
DIANE C HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1197
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64-05177
MEDICA
MN
01
—
912S9HE
BCBS-MINNESOTA
MN
01
—
HP47697
HEALTHPARTNERS
MN
Enumeration date
08/30/2006
Last updated
07/08/2007
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