Individual
JESSICA LYNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2015 HENNEPIN AVE N, GLENCOE, MN 55336-1446
(320) 864-7790
Mailing address
7355 COUNTY ROAD 140, COLOGNE, MN 55322-9161
(952) 649-7071
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
11134
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11134
MINNESOTA BOARD OF PHYSICAL THERAPY
MN
Enumeration date
11/29/2018
Last updated
11/29/2018
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