Individual
LISA MARIE JUAREZ BOSTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 THOMPSON AVE W, WEST SAINT PAUL, MN 55118-3100
(651) 587-7522
Mailing address
1756 DODD RD, SAINT PAUL, MN 55118-3729
(651) 587-7522
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
04/04/2007
Last updated
02/25/2026
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