Jaclyn Nicole Tarnowski, PTA

Individual provider Active NPI Physical Therapy Assistant · Arthur, ND

NPI 1679926331 · NPPES record last updated Jul 18, 2016

Key facts

NPI
1679926331
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1179 (ND)
Practice address
150 County Road 34
Arthur, ND 58006-4102
Phone
(701) 967-8316
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1179NDMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1179 ND Yes

Addresses

Primary practice location

150 County Road 34
Arthur, ND 58006-4102

Mailing address

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Phone (503) 570-3665

Other providers in Arthur, ND

All providers in Arthur, ND · Physical Therapy Assistant in North Dakota

Sources for this page

Verify at the official NPI Registry.