Individual
MISS JODI LYNN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
111 17TH AVE E, ALEXANDRIA, MN 56308-5273
(320) 762-1144
(320) 762-1935
Mailing address
111 17TH AVE E, ALEXANDRIA, MN 56308-5273
(320) 762-1144
(320) 762-1935
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1444
MN
2255A2300X
Athletic Trainer
25MT00143900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1444
ATHLETIC TRAINER
MN
Enumeration date
02/28/2006
Last updated
05/17/2016
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