Individual
MRS. NANCY JOAN JACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11700 WAYZATA BLVD, MINNETONKA, MN 55305-2014
(612) 209-5240
Mailing address
PO BOX 5, LONG LAKE, MN 55356-0005
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100166
MN
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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