Individual
NATHAN GLENN ELLINGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
116 E DENVER AVE, BISMARCK, ND 58504-6430
(218) 639-7864
Mailing address
116 E DENVER AVE, BISMARCK, ND 58504-6430
(218) 639-7864
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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