Individual
JILL CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1001 E 77TH ST #208, RICHFIELD, MN 55423
(952) 594-2606
Mailing address
1001 E 77TH ST #208, RICHFIELD, MN 55423
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1859
MN
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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