Healthcare Provider Details

I. General information

NPI: 1972427748
Provider Name (Legal Business Name): JENNA BAUMGARTNER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 MAIN AVE NE
WARROAD MN
56763-2344
US

IV. Provider business mailing address

715 DELMORE DR
ROSEAU MN
56751-1599
US

V. Phone/Fax

Practice location:
  • Phone: 218-386-3155
  • Fax: 218-386-3156
Mailing address:
  • Phone: 218-463-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13339
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: