Individual
MR. VIRGIL WAYNE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC/R
Contact information
Practice address
3939 7TH AVE, ANOKA, MN 55303-1261
(763) 506-6445
Mailing address
2120 COUNTY ROAD C W, ROSEVILLE, MN 55113-2501
(763) 201-6040
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1334
MN
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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