Individual
MARIA ANNE JACENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
724 MAPLE GROVE RD, DULUTH, MN 55811-4521
(218) 724-4900
Mailing address
500 CROSS ST, BIG STONE CITY, SD 57216-8237
(605) 541-1140
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4536
MN
Other
Enumeration date
09/24/2021
Last updated
01/13/2022
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