Individual
JILL M LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2665 W 78TH ST, CHANHASSEN, MN 55317-4502
(952) 835-4512
(888) 425-0398
Mailing address
7825 3RD ST N STE 105, OAKDALE, MN 55128-5444
(952) 835-4512
(888) 425-0398
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7278
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072770
OPTUM
MN
01
—
200K5LA
BLUE CROSS MN
MN
05
—
487475700
—
MN
01
—
6404273
MEDICA
MN
01
—
HP39431
HEALTH PARTNERS
MN
Enumeration date
06/30/2006
Last updated
07/19/2021
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