Individual
MS. MARIELLE LOUISE GATENBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
406 N FAXON RD, NORWOOD YOUNG AMERICA, MN 55368-9507
(952) 467-1915
Mailing address
4234 90TH ST, GLENCOE, MN 55336-5505
(952) 467-1915
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1085
MN
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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