Individual provider · NPI-1

Andrew Carlson, LAT, ATC

Specialist/Technologist, Athletic Trainer · Fargo, ND

NPI number1972957843
StatusActive
Last updated in NPPESApr 18, 2016

Details

NPI
1972957843
Entity type
Individual (NPI-1)
Name
Andrew Carlson
Credential
LAT, ATC
Sex
Male
Sole proprietor
No
Enumeration date
Apr 18, 2016
Last updated
Apr 18, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer536-14NDYes

Practice location

2301 25th St S
Fargo, ND 58103

Phone 701-417-6000

Mailing address

1920 21st Ave S
Apt 308
Fargo, ND 58103

Phone 701-317-1473

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Specialist/Technologist, Athletic Trainer providers in Fargo, ND