Individual
MAIJA JOE MAANINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15959 VALE ST NW, ANDOVER, MN 55304-8418
(763) 228-5540
Mailing address
15959 VALE ST NW, ANDOVER, MN 55304-8418
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/27/2019
Last updated
01/27/2019
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