Individual
JESSE BAUERNHUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3815 W BROADWAY AVE, ROBBINSDALE, MN 55422-2207
(612) 332-4262
Mailing address
4554 CEDAR LAKE RD S APT 6, ST LOUIS PARK, MN 55416-3755
(920) 379-0527
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2434
MN
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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