Mariliz Jimenez Dykstra, DPT
Physical Therapist, Geriatrics in Crown Point, IN. Individual provider (NPI-1).
NPI number1083172233
StatusActive
Last updated in NPPESMar 6, 2019
Details
- NPI
- 1083172233
- Entity type
- Individual (NPI-1)
- Name
- Mariliz Jimenez Dykstra
- Credential
- DPT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 6, 2019
- Last updated
- Mar 6, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251G0304X | Physical Therapist, Geriatrics | 05011241A | IN | Yes |
Practice location
7573 W 121st AveCrown Point, IN 46307-8716
Phone 219-895-4103
Mailing address
7573 W 121st AveCrown Point, IN 46307-8716
Phone 219-895-4103
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