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Individual

JENNA BUCKWALTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
430 5TH ST N, BRECKENRIDGE, MN 56520-1426
(218) 641-7725
Mailing address
430 5TH ST N, BRECKENRIDGE, MN 56520-1426
(218) 641-7725

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1732
ND
225100000X
Physical Therapist
Primary
9959
MN
314000000X
Skilled Nursing Facility
9959
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1469913
ND
Enumeration date
09/12/2016
Last updated
03/16/2017
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