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Individual

JENNIFER REQUEJO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
512 49TH AVE N, MINNEAPOLIS, MN 55430-3621
(612) 607-5807
Mailing address
14670 BRUNSWICK AVE S, SAVAGE, MN 55378-2856
(507) 676-6208

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8509
MN

Other

Enumeration date
11/04/2016
Last updated
11/04/2016
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