Individual
MRS. SANDRA LYNN THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2543 7TH AVE E, SAINT PAUL, MN 55109-3004
(651) 429-9891
(651) 770-1180
Mailing address
2543 7TH AVE E, SAINT PAUL, MN 55109-3004
(651) 429-9891
(651) 770-1180
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1328
MN
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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