Individual
ADAM JOSEPH MELSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
SDSU, 2810 HPER CENTER, BROOKINGS, SD 57007-1497
(605) 688-4003
Mailing address
SDSU, 2810 HPER CENTER, BROOKINGS, SD 57007-1497
(605) 688-4003
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0523
SD
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/30/2015
Last updated
06/24/2016
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