Healthcare Provider Details

I. General information

NPI: 1336219575
Provider Name (Legal Business Name): JENNIFER KUEHNER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1681 COMMERCE DR
NORTH MANKATO MN
56003-1913
US

IV. Provider business mailing address

7581 9TH ST N SUITE 100
OAKDALE MN
55128-6626
US

V. Phone/Fax

Practice location:
  • Phone: 507-625-8017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7675
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: