Provider Demographics
NPI:1891934188
Name:SLETTEN, JEFFREY KENT (MPT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:KENT
Last Name:SLETTEN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21395 JOHN MILLESS DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-4402
Mailing Address - Country:US
Mailing Address - Phone:763-428-2589
Mailing Address - Fax:763-428-4672
Practice Address - Street 1:21395 JOHN MILLESS DR
Practice Address - Street 2:SUITE 600
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4402
Practice Address - Country:US
Practice Address - Phone:763-428-2589
Practice Address - Fax:763-428-4672
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist