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Individual

BRIDGET ANN JUHNKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
4450 31ST AVE S STE 104, FARGO, ND 58104-4557
(701) 451-9417
Mailing address
3101 49TH ST S APT 105, FARGO, ND 58104-4528
(320) 522-2262

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11326
MN
225100000X
Physical Therapist
Primary
2167
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11326
MN STATE PHYSICAL THERAPY LICENSE NUMBER
MN
01
2167
PHYSICAL THERAPY LICENSE
ND
Enumeration date
10/11/2018
Last updated
01/04/2022
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