Joshua Michael Brodersen, LAT, ATC
Specialist/Technologist, Athletic Trainer in Bloomington, MN. Individual provider (NPI-1).
NPI number1740720283
StatusActive
Last updated in NPPESApr 30, 2019
Details
- NPI
- 1740720283
- Entity type
- Individual (NPI-1)
- Name
- Joshua Michael Brodersen
- Credential
- LAT, ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 2, 2017
- Last updated
- Apr 30, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 3002 | MN | Yes |
Practice location
8100 Northland DrBloomington, MN 55431-4800
Phone 906-221-1181
Mailing address
15827 Griffon PathApple Valley, MN 55124-6661
Phone 906-221-1181
Other practice locations
1837 University Dr N Apt 318
Fargo, ND 58105-2504
Fargo, ND 58105-2504
Phone 906-221-1181
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All 31 Athletic Trainer providers in Bloomington · All 4,142 providers in Bloomington
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