Jacklitch, Nathanyal M

Jacklitch, Nathanyal M is an individual health care provider with primary practice located at 3915 Golden Valley Road Courage Center, Golden Valley MN 55422-4298. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Jacklitch, Nathanyal M can be contacted via phone (763) 520-0867.

Contact Information

Primary practice address
3915 Golden Valley Road Courage Center Golden Valley MN 55422-4298
Phone: (763) 520-0867
Fax: (763) 520-0355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 7056 Minnesota

Profile Details

NPI number 1093772881
LBN Legal business name Jacklitch, Nathanyal M
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093772881 NPPES
Other 6403628 MEDICA
Other 65G73JA MEDICA
Other HP43214 MEDICA

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