IndividualActive
Jerry Wendel Daub
NPI 1174117238 · Massage Therapist · Fargo, ND
Provider details
- NPI number
- 1174117238
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 480 (ND)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1326 25th St S
Fargo, ND 58103-3629
Phone: (701) 371-2225
Approximate (ZIP-level) locationGet directions
Mailing address
1326 25th St S
Fargo, ND 58103-3629
Registry dates
- Enumerated
- 2021-03-01
- Last updated
- 2021-03-01
- Certified
- 2021-02-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.