Individual
SAMANTHA BOURCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MATRG, ATC
Contact information
Practice address
111 17TH AVE E, SUITE 101, ALEXANDRIA, MN 56308-5273
(320) 762-1144
(320) 762-1935
Mailing address
111 17TH AVE E, SUITE 101, ALEXANDRIA, MN 56308-5273
(320) 762-1144
(320) 762-1935
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2634
MN
2255A2300X
Athletic Trainer
503-13
ND
Other
Enumeration date
11/04/2014
Last updated
03/23/2015
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