Individual
JESSICA ELIZABETH WAHLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(992) 993-2773
Mailing address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(992) 993-2773
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9731
MN
Other
Enumeration date
09/02/2014
Last updated
11/12/2015
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