Jesse Tae Dykstra

NPI #1639870025 in Great Falls, Montana

Provider Information

NPI Number: 1639870025
Entity Type: Individual
Name: Jesse Tae Dykstra
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Mar 13, 2023
Last Updated: Mar 13, 2023

Practice Location

Address: 1500 32ND ST S
City: Great Falls
State: Montana
ZIP Code: 59405-5300
Phone: (406) 761-4300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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