Male or Other

Nik Gustafson ATC

Athletic Trainer in Chaska, MN(View on Map)

Full Name

Nik Gustafson ATC

NPI Number

1386192276

NPI Type

Individual Provider

Gender

Male

Enumeration Date

09/20/2016

Specialties

(Taxonomies)

Code

2255A2300X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

2824

Contact
Information

Purpose

Mailing
Location

Address

110105 PIONEER TRL W
110105 PIONEER TRL W

City

Chaska
Chaska

State

MN
MN

Postal Code

55318-2680
55318-2680

Country

US
US

Telephone Number

N/A
(952) 512-4270

Identifiers

Identifier

225A2300X

Identifier State

MN

Identifier Issuer

REHABILITATION SERVICES

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/20/2016

Provider Address

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