Provider Demographics
NPI:1356969158
Name:TUHOLSKY, JACOB PATRICK (DPT)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:PATRICK
Last Name:TUHOLSKY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9434 W BROEK DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-5833
Mailing Address - Country:US
Mailing Address - Phone:612-839-8112
Mailing Address - Fax:
Practice Address - Street 1:1101 BROADWAY AVE STE 115B
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-2836
Practice Address - Country:US
Practice Address - Phone:605-260-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist