Nicholas T Allard, PT
Individual provider Active NPI Physical Therapist · Moose Lake, MN
NPI 1609494657 · NPPES record last updated Jul 7, 2020
Key facts
- NPI
- 1609494657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10714 (MN)
- Practice address
- 4572 County Road 61
Moose Lake, MN 55767-9401 - Phone
- (218) 485-4481
- NPI assigned
- Jul 7, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10714 | MN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10714 | MN | Yes |
Addresses
Primary practice location
4572 County Road 61
Moose Lake, MN 55767-9401
Mailing address
1702 University Dr S
Fargo, ND 58103-4940
Other providers in Moose Lake, MN
- Megyn Kolleen Albrecht
- Andrew Ames
- Melissa Jean Anderson
- Augustana Mercy Care Center LLC
- Augustana Mercy Care Center LLC
- Augustana Oakview Care, LLC
All providers in Moose Lake, MN · Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.