NPI 1013456292

Jesse Differding

Practitioner Athletic Trainer Breckenridge, MN

Practice location

Address: 3579 US Highway 75, Breckenridge, MN 56520-9467
Phone: (701) 403-4021

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

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Registry record

NPI: 1013456292
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Feb 2017
Record last updated: 21 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.