JESSICA DEFORREST

ROBBINSDALE, MN
NPI1508133190
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN  1755)
Enumeration Date2011-11-26
Last Update Date2011-11-26
Business Address
-- JESSICA DEFORREST MA, ATC
4080 W BROADWAY AVE STE 300
ROBBINSDALE, MN 55422-5607
Phone number: 651-231-8379
Mailing Address
-- JESSICA DEFORREST MA, ATC
470 HICKORY LN N
OAKDALE, MN 55128-7037
Phone number:
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