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Individual

GENEVIEVE PETRICKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
110105 PIONEER TRL, SUITE 201, CHASKA, MN 55318-2680
(952) 512-2470
Mailing address
15360 18TH AVE N, APT 1009, PLYMOUTH, MN 55447-2429

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2892
MN

Other

Enumeration date
03/16/2017
Last updated
03/16/2017
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