Individual
JENS K MATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT. DPT, OCS, CMPT
Contact information
Practice address
520 N CANYON ST, SPEARFISH, SD 57783-2320
(605) 642-7996
(605) 642-5955
Mailing address
520 N CANYON ST, SPEARFISH, SD 57783-2320
(605) 642-7996
(605) 642-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2085
SD
225100000X
Physical Therapist
60718
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R194790
MEDICARE
OR
Enumeration date
08/12/2014
Last updated
10/09/2020
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