Individual
JORDYN MARISA LIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
701 DELLWOOD ST S, CAMBRIDGE, MN 55008-1920
(763) 689-8700
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
15242
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/31/2018
Last updated
04/16/2025
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