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Individual

JUSTIN MICHAEL ROST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, CSCS, MSE

Contact information

Practice address
2850 ABBEY PLAZA, COLLEGEVILLE, MN 56321
(320) 363-3105
Mailing address
29353 LINDBERGH LN, AVON, MN 56310-9672
(952) 221-6810

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2491
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2491
ATHLETIC TRAINER
MN
Enumeration date
03/27/2015
Last updated
03/27/2015
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