Healthcare Provider Details

I. General information

NPI: 1063342426
Provider Name (Legal Business Name): JENNA JORGENSON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CROSS ST
BIG STONE CITY SD
57216-8237
US

IV. Provider business mailing address

3019 7TH ST SW
WATERTOWN SD
57201-7648
US

V. Phone/Fax

Practice location:
  • Phone: 605-541-1121
  • Fax: 320-287-0336
Mailing address:
  • Phone: 605-520-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14081
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: