Provider Demographics
NPI:1326776782
Name:HOVDE, NICHOLAS DEAN (PT)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:DEAN
Last Name:HOVDE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 12938
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58208-2938
Mailing Address - Country:US
Mailing Address - Phone:701-746-8374
Mailing Address - Fax:701-780-0885
Practice Address - Street 1:1421 CENTRAL AVE NW
Practice Address - Street 2:
Practice Address - City:EAST GRAND FORKS
Practice Address - State:MN
Practice Address - Zip Code:56721-1617
Practice Address - Country:US
Practice Address - Phone:218-773-3388
Practice Address - Fax:218-773-6611
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN12812225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist