Provider Demographics
NPI:1356010789
Name:MOHS, MAKAYLA L (DPT)
Entity Type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:L
Last Name:MOHS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MAKAYLA
Other - Middle Name:
Other - Last Name:REUTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3060 FRONTIER WAY S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8909
Mailing Address - Country:US
Mailing Address - Phone:701-232-2340
Mailing Address - Fax:701-232-2330
Practice Address - Street 1:3060 FRONTIER WAY S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8909
Practice Address - Country:US
Practice Address - Phone:701-232-2340
Practice Address - Fax:701-232-2330
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2578225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist