Individual
JALISA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8100 NORTHLAND DR., MINNEAPOLIS, MN 55431
(952) 831-8742
Mailing address
8100 NORTHLAND DR., MINNEAPOLIS, MN 55431
(952) 831-8742
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2723
MN
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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