NPI 1962950667 · live from the CMS NPI Registry
Jenna Buckwalter, DPT
Physical Therapist in Breckenridge, MN. National Provider Identifier 1962950667, active.
NPI record
| NPI | 1962950667 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 430 5th St N, Breckenridge, MN 56520 |
| Practice phone | 218-641-7725 |
| Enumerated | September 12, 2016 |
| Last updated | March 16, 2017 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility | 314000000X | 9959 (MN) |
| Physical Therapist primary | 225100000X | 9959 (MN) |
| Physical Therapist | 225100000X | 1732 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.