Individual
JODI M ZUPANCICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7815 3RD ST N STE 203, OAKDALE, MN 55128-5443
(952) 835-4512
(952) 300-2004
Mailing address
7815 3RD ST N STE 203, OAKDALE, MN 55128-5443
(952) 835-4512
(952) 300-2004
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1273-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1273-019
PTA
WI
01
—
A1765
MN STATE
MN
Enumeration date
07/21/2006
Last updated
03/25/2015
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