Jared Van Winkle, PT, DPT
Physical Therapist in Wagner, SD. Individual provider (NPI-1).
NPI number1457950321
StatusActive
Last updated in NPPESOct 21, 2020
Details
- NPI
- 1457950321
- Entity type
- Individual (NPI-1)
- Name
- Jared Van Winkle
- Credential
- PT, DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 21, 2020
- Certification date
- Oct 21, 2020
- Last updated
- Oct 21, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 2117 | SD | Yes |
Practice location
513 3rd St SwWagner, SD 57380-9675
Phone 605-384-3611
Mailing address
302 E 14th AveTyndall, SD 57066-2254
Phone 605-857-0043
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