Individual
MR. JACOB CHRISTIAN HARLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, ATC
Contact information
Practice address
30 FAIRVIEW AVE S STE 200, SAINT PAUL, MN 55105-1463
(952) 835-4512
Mailing address
1039 BLAIR AVE, SAINT PAUL, MN 55104-2117
(641) 512-4594
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
13311
MN
225100000X
Physical Therapist
Primary
109035
IA
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
05/02/2018
Last updated
11/14/2024
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