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MS. MARIELLE LOUISE GATENBY ATC

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

Registrant NPI Number: 1285705087

Individual Registrant:
MS. MARIELLE LOUISE GATENBY ATC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
406 N FAXON RD  NORWOOD YOUNG AMERICA, MN 55368-9507 US
Tel: 952-467-1915  Fax: --

Contact information for business:
4234 90TH ST  GLENCOE, MN 55336-5505 US
Tel: 952-467-1915  Fax: --

Registration Information:
NPI: 1285705087
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
MN1085

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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