Individual
JILLIAN MARIE DRIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8100 W 78TH ST STE 230, EDINA, MN 55439-2570
(320) 552-1348
Mailing address
4350 TRENTON LN N APT 204, PLYMOUTH, MN 55442-2824
(320) 552-1348
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3427
MN
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/07/2019
Last updated
07/17/2024
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