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Individual

MRS. LISA MARIE BOBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
8100 NORTHLAND DR, BLOOMINGTON, MN 55431-4800
(952) 831-8742
Mailing address
7105 RIVERVIEW TER NE, FRIDLEY, MN 55432-3046
(608) 332-8400

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2053
MN

Other

Enumeration date
12/19/2016
Last updated
12/19/2016
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