Most Relevant Information
Provider Data
| NPI Number: | 1003397316 |
| Provider Name: | MIKAELA JOY DICK DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PTL.0015935 |
Most Important Dates
| Enumeration Date: | 08/24/2018 |
| Last Updated: | 11/10/2020 |
Provider Practice Location
1461 BROADWAY N
FARGO
ND
581022622
Practice Location Phone/Fax
| Phone: | 7012936037 |
| Fax: |
Provider Mailing Location
1461 BROADWAY N
FARGO
ND
581022622
Provider Mailing Phone/Fax
| Phone: | 7012936037 |
| Fax: |