Healthcare Provider Details

I. General information

NPI: 1851466114
Provider Name (Legal Business Name): JODY MARY FRANZ PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 COUNTY ROAD 120 SUITE A
SAINT CLOUD MN
56303
US

IV. Provider business mailing address

251 COUNTY ROAD 120 SUITE A
SAINT CLOUD MN
56303
US

V. Phone/Fax

Practice location:
  • Phone: 320-259-5429
  • Fax: 320-240-8905
Mailing address:
  • Phone: 320-259-5429
  • Fax: 320-240-8905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4923
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: