Individual
CAMERON JACOB THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1601 SAINT FRANCIS AVE STE 200, SHAKOPEE, MN 55379-3385
(952) 892-2000
Mailing address
8418 GROVE PL, SHAKOPEE, MN 55379-8518
(605) 799-6544
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12429
MN
Other
Enumeration date
08/31/2021
Last updated
01/27/2025
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