Individual
EVERETT FANDRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6118 COUNTY ROAD 82 NW, ALEXANDRIA, MN 56308-8213
(320) 815-1540
Mailing address
6118 COUNTY ROAD 82 NW, ALEXANDRIA, MN 56308-8213
(320) 815-1540
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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