MEDICARE: AIMEE JEANETTE BETTICH 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
1	225100000X	Physical Therapist	11079	MN

General Provider Information

NPI Number	:	1801771688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE JEANETTE BETTICH PT, DPT

Provider Business Mailing Address
First Line	:	17888 ORLANDO AVE
Second Line	:
City	:	HASTINGS
State	:	MN
Zip	:	55033-9652
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	916 8TH ST
Second Line	:
City	:	FARMINGTON
State	:	MN
Zip	:	55024-1438
Country	:	US
Telephone Number	:	651-460-4201
Fax Number	:

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

Provider Enumeration Date	:	08/09/2025
Last Update Date	:	08/09/2025

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