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Individual

DIANA D BOCKLUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LAT, ATC, FF/EMT

Contact information

Practice address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(651) 247-7315
Mailing address
7820 64TH ST N, PINE SPRINGS, MN 55115-6805
(651) 247-7315

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2704
MN

Other

Enumeration date
01/17/2019
Last updated
01/17/2019
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