Ellie Sue Diercks

NPI #1972527166 in Red Wing, Minnesota

Provider Information

NPI Number: 1972527166
Entity Type: Individual
Name: Ellie Sue Diercks
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Jul 27, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 701 FAIRVIEW BLVD
City: Red Wing
State: Minnesota
ZIP Code: 55066-2848
Phone: (651) 267-5000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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