Individual
LAURA ETTLIN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3915 GOLDEN VALLEY RD # TRP, GOLDEN VALLEY, MN 55422-4249
(612) 775-2499
Mailing address
5424 ROWLAND RD, MINNETONKA, MN 55343-8916
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
—
MN
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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