Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Hunter Lake, PT, DPT

Individual provider Physical Therapist · NPI 1255172482

Hunter Lake, PT, DPT is a Physical Therapist in Private Practice in East Grand Forks, Minnesota. Qualified in 2024, 2 years ago. Practices with Sanford Medical Center Fargo, a 1,212-clinician group and accepts Medicare assignment. Licensed in North Dakota.

Years since qualifying
2
Licensed in
ND
In the registry since
2024
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

625 Demers Ave
East Grand Forks, MN 56721-1833
Phone: (218) 773-5858
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2703 (ND)

Record details

NPI number1255172482
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedJune 3, 2024
Last updated in NPPESJuly 13, 2024
Certification dateJuly 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Sanford Medical Center Fargo — 1212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in East Grand Forks