NPI 1013359579

Todd Michael Thieman

Practitioner Driver Wyoming, MN

Practice location

Address: 204 Hawthorne Rd, Wyoming, MN 55092-9717
Phone: (651) 464-7444
Fax: (651) 464-7444

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 377643 (MN)

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Registry record

NPI: 1013359579
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jul 2013
Record last updated: 25 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.