Individual
KESENYA HAVLICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4040 RADIO DR, WOODBURY, MN 55129-3237
(651) 439-8807
Mailing address
740 W 229TH ST, JORDAN, MN 55352-9459
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
05/09/2022
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