Individual
JESSICA IRENE WILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5430 BOONE AVE N, NEW HOPE, MN 55428-3615
(763) 592-2600
Mailing address
5514 154TH CT NW, RAMSEY, MN 55303-4046
(218) 277-9039
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2947
MN
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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