Individual
JENNIFER LYNN FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 395-5454
Mailing address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 395-5454
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5951-024
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40300500
—
WI
Enumeration date
11/20/2006
Last updated
07/08/2007
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