Individual
GABRIELLE LANGERUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 E 17TH ST, BLOOMINGTON, IN 47408-1590
(320) 493-3783
Mailing address
21878 FOREST HILL RD, RICHMOND, MN 56368-8315
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003604A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2019
Last updated
09/06/2023
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