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Individual

JEREMY ST. AUBIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
612 CENTER AVE N, ASHLEY, ND 58413-7013
(701) 288-5243
Mailing address
PO BOX 450, ASHLEY, ND 58413-0450

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1179
ND
2251P0200X
Pediatric Physical Therapist
1262
SD

Other

Enumeration date
10/26/2016
Last updated
10/26/2016
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