Individual
MRS. DYAN MARIE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICALTHERAPISTMPT
Contact information
Practice address
1620 17TH ST NW, FARIBAULT, MN 55021-2839
(507) 332-2204
(507) 332-2270
Mailing address
1205 2ND ST NW, ROCHESTER, MN 55901-0360
(507) 288-4416
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6156
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11613
U-CARE PROVIDER #
MN
01
—
2032898
ARAZ IND PROVIDER #
MN
01
—
33G05JA
BCBS INDIVIDUAL PROVIDER#
MN
01
—
6401148
MEDICA IND PROVIDER #
MN
01
—
HP42458
HEALTH PARTNERS IND PRO#
MN
Enumeration date
02/10/2006
Last updated
07/09/2007
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