Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 8576 | MN |
NPI | 1033561238 |
---|---|
Provider Name | Dr. Nicholas Bliek |
First Address | Eagan, MN 55123-1994 |
Second Address | Minneapolis, MN 55407-3723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2016 |
Last Update Date | 10/11/2021 |