Individual
MRS. BRENDA JOELLE LARSON DOLEJS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, ATR
Contact information
Practice address
4080 W BROADWAY AVE, SUITE 300, ROBBINSDALE, MN 55422-5604
(612) 672-7109
Mailing address
13875 FRANCHISE AVE, APPLE VALLEY, MN 55124-5616
(952) 431-2524
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1008
MN
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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