Provider Demographics
NPI:1659547420
Name:NIENOW, JAMES FRANCIS JR (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FRANCIS
Last Name:NIENOW
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 PINNACLE WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-4282
Mailing Address - Country:US
Mailing Address - Phone:651-731-3993
Mailing Address - Fax:
Practice Address - Street 1:4707 NORTH RD
Practice Address - Street 2:
Practice Address - City:CIRCLE PINES
Practice Address - State:MN
Practice Address - Zip Code:55014-1545
Practice Address - Country:US
Practice Address - Phone:763-792-5388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist