Jacob Kretschmar, PT, DPT
Individual provider Active NPI Orthopedic Physical Therapist · Spicer, MN
NPI 1326309709 · NPPES record last updated Jun 2, 2012
Key facts
- NPI
- 1326309709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 8219083-2401 (UT)
- Practice address
- 13274 53Rd St NE
Spicer, MN 56288-9437 - Phone
- (701) 550-9142
- NPI assigned
- Jun 2, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8219083-2401 | UT | MD | Orthopedic Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 8219083-2401 | UT | Yes |
Addresses
Primary practice location
13274 53Rd St NE
Spicer, MN 56288-9437
Mailing address
PO Box 429
Rolla, ND 58367-0429
Phone (701) 550-9142
Other providers in Spicer, MN
- Glacial Lakes Aesthetics LLC
- Green Lake Thrifty White Drug Inc
- Kirby Melvin Johnson
- Kirby M. Johnson, D.D.S., LLC
- Tammie Lyn Knick
- Elizabeth J Mangen
- Benjamin Marvin Olson
- Paynesville Area Hospital District
- Peterson Wellness Clinic P.a.
- Brooke Sara Peterson
All providers in Spicer, MN · Orthopedic Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.