Individual
SAMUEL JOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6025 LAKE RD STE 200, WOODBURY, MN 55125-1710
(651) 999-6800
Mailing address
3001 METRO DR STE 460, BLOOMINGTON, MN 55425-1548
(651) 999-6800
(651) 999-6970
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15239
MN
Other
Enumeration date
09/04/2019
Last updated
08/20/2025
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