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Individual

DR. SARA JESSE GLEASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, PT

Contact information

Practice address
911 NORTHLAND DR, PRINCETON, MN 55371-2172
(763) 389-1313
Mailing address
1891 STATION NWPKWY, ANDOVER, MN 55304-4259
(763) 755-4275

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4503
TEMPORARY PERMIT TO PRACTICE PHYSICAL THERAPY
MN
Enumeration date
06/26/2017
Last updated
04/29/2021
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