Matthew Brian Biancuzzo
Specialist/Technologist, Athletic Trainer in Minneapolis, MN. Individual provider (NPI-1).
NPI number1164929857
StatusActive
Last updated in NPPESApr 9, 2018
Details
- NPI
- 1164929857
- Entity type
- Individual (NPI-1)
- Name
- Matthew Brian Biancuzzo
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 9, 2018
- Last updated
- Apr 9, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 3089 | MN | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 0506310 | NV |
Practice location
1 Twins WayMinneapolis, MN 55403-1418
Phone 401-489-3394
Mailing address
2654 W Horizon Ridge Pkwy # B5-254Henderson, NV 89052-2803
Phone 401-489-3394
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