Individual
NICOLE GORVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATR
Contact information
Practice address
5101 HIGHWAY 101, MINNETONKA, MN 55345-4163
(952) 512-4200
Mailing address
4621 MANCHESTER RD, MOUND, MN 55364-9141
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2578
MN
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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