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Individual

MRS. JILL CHRISTINE ANDERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
HWY 1 HOSPITAL DR. BOX 497, RED LAKE, MN 56671
(218) 679-3912
(218) 679-0181
Mailing address
HWY 1 HOSPITAL DR. BOX 497, RED LAKE, MN 56671
(218) 679-3912

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5804
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508809765
MN
Enumeration date
12/13/2010
Last updated
12/13/2010
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