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JESSE ANDERSON ATC

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1538661186

Individual Registrant:
 JESSE  ANDERSON ATC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
102 IVERSON ST W  SAINT JOSEPH, MN 56374-4650 US
Tel: 320-226-5380  Fax: --

Contact information for business:
102 IVERSON ST W  SAINT JOSEPH, MN 56374-4650 US
Tel: 320-226-5380  Fax: --

Registration Information:
NPI: 1538661186
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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