Individual
MR. MICHAEL R GNACINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1140 EDWARDS VILLAGE BUILDING 105, EDWARDS, CO 81632
(970) 569-3240
(970) 569-3260
Mailing address
PO BOX 2743, 1140 EDWARDS VILLAGE B-105, EDWARDS, CO 81632-2743
(970) 569-3240
(970) 659-3260
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
783
CO
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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