Male or Other

Mr. Nathan M. Tellers ATC

Athletic Trainer in St Bonifacius, MN(View on Map)

Full Name

Mr. Nathan Michael Tellers ATC

NPI Number

1922092675

NPI Type

Individual Provider

Gender

Male

Enumeration Date

09/08/2005

Specialties

(Taxonomies)

Code

2255A2300X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

1745

Contact
Information

Purpose

Mailing
Location

Address

4246 SPRUCE RD
4246 SPRUCE RD

City

St Bonifacius
St Bonifacius

State

MN
MN

Postal Code

55375-1315
55375-1315

Country

US
US

Telephone Number

(952) 467-1915
(952) 467-1915

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

Data last updated by provider on 07/08/2007

Provider Address

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