Provider Demographics
NPI:1982808226
Name:JAHNER PT & FITNESS, INC.
Entity Type:Organization
Organization Name:JAHNER PT & FITNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAHNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:701-523-7848
Mailing Address - Street 1:108 N MAIN ST
Mailing Address - Street 2:PO BOX 328
Mailing Address - City:BOWMAN
Mailing Address - State:ND
Mailing Address - Zip Code:58623-0328
Mailing Address - Country:US
Mailing Address - Phone:701-523-7848
Mailing Address - Fax:
Practice Address - Street 1:108 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BOWMAN
Practice Address - State:ND
Practice Address - Zip Code:58623-0328
Practice Address - Country:US
Practice Address - Phone:701-523-7848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDN712633Medicare PIN