Individual
JACOB MARK JANUSZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
301 N BROADWAY, PELICAN RAPIDS, MN 56572-4113
(218) 863-2000
Mailing address
301 N BROADWAY, PELICAN RAPIDS, MN 56572-4113
(218) 863-2000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1570
ND
225100000X
Physical Therapist
Primary
8522
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366728412
—
MN
Enumeration date
11/02/2011
Last updated
02/09/2022
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