Nathanyal M Jacklitch MPT

NPI 1093772881 - Physical Therapist - 225100000X

NPI Details
NPI 1093772881
Gender Male
Enumeration Date 04/27/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3915 GOLDEN VALLEY ROAD
COURAGE CENTER
GOLDEN VALLEY MN, 55422-4298, US
Phone (763) 520-0867
Fax (763) 520-0355
Business Location
3915 GOLDEN VALLEY ROAD
COURAGE CENTER
GOLDEN VALLEY MN, 55422-4298, US
Phone (763) 520-0867
Fax (763) 520-0355
Toxanomy
Taxonomy Code 225100000X
License State Minnesota
License Number 7056
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According to our database, Nathanyal M Jacklitch MPT NPI is 1093772881, taxonomy code is 225100000X and license number is 7056, license state is located at Minnesota. Nathanyal M Jacklitch MPT physically located at 3915 Golden Valley Road, Golden Valley MN, 55422-4298. NPI Number Nathanyal M Jacklitch MPT has the Individual type.

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1093772881 NPI number is provided on an as is basis without warranty of any kind. 1093772881 is maintained by the National Plan & Provider Enumeration System. The contents of Nathanyal M Jacklitch MPT are for informational purposes only.