Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath | ||
N | 225700000X | Massage Therapist |
NPI | 1801211586 |
---|---|
Provider Name | Jillyne Bobrowsky |
First Address | Minnetonka, MN 55345-3405 |
Second Address | Victoria, MN 55386 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2014 |
Last Update Date | 04/03/2014 |