Healthcare Provider Details

I. General information

NPI: 1427981810
Provider Name (Legal Business Name): ISAIAH KLUDT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 2ND AVE N
HETTINGER ND
58639-7448
US

IV. Provider business mailing address

107 2 1/2 AVE SW
HETTINGER ND
58639-9580
US

V. Phone/Fax

Practice location:
  • Phone: 701-567-8910
  • Fax:
Mailing address:
  • Phone: 701-928-1564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2919
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: