Individual
JEFFREY JAMES CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M ED, ATC
Contact information
Practice address
2104 NORTHDALE BLVD NW, SUITE 100, COON RAPIDS, MN 55433-3005
(763) 755-5495
Mailing address
3777 114TH LN NW, COON RAPIDS, MN 55433-2607
(763) 323-1732
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/12/2006
Last updated
07/08/2007
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