Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5857 | MN |
N | 2251N0400X | Physical Therapist - Neurology | 5857 | MN |
NPI | 1255571923 |
---|---|
Provider Name | Jessica Kay Leagjeld |
First Address | Saint Paul, MN 55101-2502 |
Second Address | Saint Paul, MN 55101-2502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2009 |
Last Update Date | 20/02/2009 |