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NPI Code Detail

MEDICARE: SANDRA JUNGWIRTH PT,DPT

MEDICARE: SANDRA JUNGWIRTH PT,DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist0198SD

General Provider Information

NPI Number : 1265884217
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA JUNGWIRTH PT,DPT
Provider Business Mailing Address
First Line : 111 W 10TH AVE
Second Line : PO BOX 420
City : REDFIELD
State : SD
Zip : 57469-1519
Country : US
Telephone Number : 605-472-1110
Fax Number :
Provider Business Practice Location Address
First Line : 111 W 10TH AVE
Second Line :
City : REDFIELD
State : SD
Zip : 57469-1519
Country : US
Telephone Number : 605-472-1110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2016
Last Update Date : 07/01/2016

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Directions to “ SANDRA JUNGWIRTH PT,DPT” Practice Location

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