Individual
ANDREA GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3103 E CALGARY AVE APT 106, BISMARCK, ND 58503-1338
(701) 317-3349
Mailing address
3103 E CALGARY AVE APT 106, BISMARCK, ND 58503-1338
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
ND
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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