Individual ProviderJacob P RetzerPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1615 Capitol Way, Bismarck, ND 58501-2218(701) 451-0410PECOS EnrollmentBased on the most recent information from CMS, provider Jacob P Retzer does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1821527003Provider TypeIndividualFull NameRetzer, Jacob PCredentialPT, DPTGenderMaleSole ProprietorNoEnumeration Date6/9/2017Last Updated11/15/2021Contact InformationPractice LocationPractice Address1615 Capitol Way, Bismarck, ND 58501-2218Phone(701) 451-0410FaxUnlisted FaxMailing LocationMailing Address1615 Capitol Way, Bismarck, ND 58501-2218Phone(701) 451-0410FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense12971Montana