Individual
REBECCA JEAN VANDERWERF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
541 LAKERIDGE DR, SHOREVIEW, MN 55126-2321
(651) 208-4340
Mailing address
541 LAKERIDGE DR, SHOREVIEW, MN 55126-2321
(651) 208-4340
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2050
MN
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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