Individual
LEAH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 BETHEL DR, MSC2376, SAINT PAUL, MN 55112-6902
(651) 638-6215
(651) 635-8676
Mailing address
3900 BETHEL DR, MSC2376, SAINT PAUL, MN 55112-6902
(651) 638-6215
(651) 635-8676
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1447
WY
225100000X
Physical Therapist
Primary
9032
MN
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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