Female

Lisa M. Jenson ATC

Athletic Trainer in Blaine, MN(View on Map)

Full Name

Lisa M Jenson ATC

NPI Number

1104040047

NPI Type

Individual Provider

Gender

Female

Enumeration Date

04/12/2007

Specialties

(Taxonomies)

Code

2255A2300X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

1453

Contact
Information

Purpose

Mailing
Location

Address

16317 WINTERGREEN ST NW
12555 UNIVERSITY AVE NW

City

Andover
Blaine

State

MN
MN

Postal Code

55304-7734
55434

Country

US
US

Telephone Number

(763) 783-0849
(763) 506-6729

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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