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1508797051

NPI Code Detail

MEDICARE: JEFFREY JAMES BREYEN

MEDICARE: JEFFREY JAMES BREYEN

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
1	225100000X	Physical Therapist	6457	MN

General Provider Information

NPI Number	:	1508797051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY JAMES BREYEN

Provider Business Mailing Address
First Line	:	12492 MEKINOK LN NE
Second Line	:
City	:	BEMIDJI
State	:	MN
Zip	:	56601-9982
Country	:	US
Telephone Number	:	218-766-7809
Fax Number	:	218-333-5766

Provider Business Practice Location Address
First Line	:	2017 NET WAY NW
Second Line	:
City	:	BEMIDJI
State	:	MN
Zip	:	56601-5147
Country	:	US
Telephone Number	:	218-333-6351
Fax Number	:	218-333-5766

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ JEFFREY JAMES BREYEN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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