Individual
LISA A CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
2751 2ND AVE N, HYSLOP SPORT CENTER ROOM 144, GRAND FORKS, ND 58202-6060
(701) 780-2977
Mailing address
2751 2ND AVE N, HYSLOP SPORT CENTER ROOM 144, GRAND FORKS, ND 58202-6060
(701) 780-2977
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
690-15
ND
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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