Individual
JACKIE LYNN BOSSHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
10230 BALTIMORE ST NE STE 300, BLAINE, MN 55449-4674
(651) 968-5201
(651) 968-5903
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103609
MN
Other
Enumeration date
11/24/2008
Last updated
12/11/2023
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