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Individual

MISS JENNIFER ELLEN BACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
4415 W 36 1/2 ST, ST LOUIS PARK, MN 55416-4854
(952) 927-9717
Mailing address
4415 W 36 1/2 ST, ST LOUIS PARK, MN 55416-4854
(952) 927-9717

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1121507
TX
225100000X
Physical Therapist
Primary
8683
MN

Other

Enumeration date
11/10/2009
Last updated
03/20/2011
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