Individual
JODIE LEE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7455 VILLAGE DR, LINO LAKES, MN 55014-1181
(651) 717-3480
Mailing address
352 CARL ST, LINO LAKES, MN 55014-3014
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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