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Individual

MATTHEW TEMBROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
251 COUNTY ROAD 120, SUITE A, SAINT CLOUD, MN 56303-4872
(320) 259-5429
(320) 240-8905
Mailing address
251 COUNTY ROAD 120, SUITE A, SAINT CLOUD, MN 56303-4872
(320) 259-5429
(320) 240-8905

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10472
MN
225100000X
Physical Therapist
2305210154
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0064-0032705
MEDICA
MN
Enumeration date
05/16/2016
Last updated
08/08/2016
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