Provider Demographics
NPI:1699705368
Name:BINSTOCK, JESSIE (PT)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:BINSTOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 21ST ST W STE D1
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-2647
Mailing Address - Country:US
Mailing Address - Phone:701-483-1000
Mailing Address - Fax:701-483-1001
Practice Address - Street 1:448 21ST ST W STE D1
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-2647
Practice Address - Country:US
Practice Address - Phone:701-483-1000
Practice Address - Fax:701-483-1001
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist