Individual
JONI VANSELOW
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4010 W 65TH ST, SUITE 105, EDINA, MN 55435-1721
(952) 285-2840
(952) 285-2830
Mailing address
6933 BLACK DUCK DR, LINO LAKES, MN 55014-1319
(651) 426-8830
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2169
MN
Other
Enumeration date
08/09/2005
Last updated
07/08/2007
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