Justin W Berry, PT DPT
Individual provider Active NPI Physical Therapist · Grand Forks, ND
NPI 1457554941 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457554941
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1202 (ND)
- Practice address
- 1000 South Columbia Road
Grand Forks, ND 58206-6002 - Phone
- (701) 780-5340
- Fax
- (701) 780-1942
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 7210 | MN | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1202 | ND | Yes |
| Physical Therapist | 225100000X | 7210 | MN |
Addresses
Primary practice location
1000 South Columbia Road
Grand Forks, ND 58206-6002
Mailing address
PO Box 6002
Grand Forks, ND 58206-6002
Phone (701) 780-5340
Other providers in Grand Forks, ND
- Chantel Bergquist
- Jaxon Bergum
- Irene J Berndt
- Lisa Michelle Bernhardt
- Mary Lynn Berntson
- Autumn Bertch
- Caitlin Bertsch
- Zane Besler
- Danielle Lynn Beyer-Langerud
- Beyond Human Chiropractic PLLC
All providers in Grand Forks, ND · Physical Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.