Organization
BACKSTROM PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN BACKSTROM (PHYSICAL THERAPIST)
(701) 351-0775
Entity
Organization
Contact information
Practice address
215 HIGHWAY 2 SW STE 103, RUGBY, ND 58368-2407
(701) 351-0775
Mailing address
215 HIGHWAY 2 SW STE 103, RUGBY, ND 58368-2407
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1755
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1987654321
—
ND
Enumeration date
08/22/2018
Last updated
08/22/2018
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