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Individual

JANEY BULSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
430 5TH ST N, BRECKENRIDGE, MN 56520-1426
(218) 641-7725
Mailing address
430 5TH ST N, BRECKENRIDGE, MN 56520-1426
(218) 641-7725

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0545
SD
2255A2300X
Athletic Trainer
Primary
2777
MN
2255A2300X
Athletic Trainer
696-15
ND

Other

Enumeration date
03/08/2017
Last updated
03/08/2017
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