Individual
MRS. JODY SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9060 GRANGE RD NW, BEMIDJI, MN 56601-9210
(218) 751-1074
Mailing address
9060 GRANGE RD NW, BEMIDJI, MN 56601-9210
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A858
MN
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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