Jeremy Anderson
Individual provider Active NPI Occupational Therapist · Hallock, MN
NPI 1922867993 · NPPES record last updated Mar 13, 2024
Key facts
- NPI
- 1922867993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 103234 (MN)
- Practice address
- 1010 S Birch Ave
Hallock, MN 56728-4215 - Phone
- (218) 843-3612
- NPI assigned
- Mar 13, 2024
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103234 | MN | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 103234 | MN | Yes |
Addresses
Primary practice location
1010 S Birch Ave
Hallock, MN 56728-4215
Mailing address
1010 S Birch Ave
Hallock, MN 56728-4215
Other providers in Hallock, MN
- Anderson Pharmacy
- Kristin Marie Atwood
- Julie A. J. Johnson
- Kittson Central School District #2171
- Kittson County
- Kittson Dental Clinic PA
All providers in Hallock, MN · Occupational 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 Mar 13, 2024. 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.