Individual
MR. NATHAN MICHAEL TELLERS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4246 SPRUCE RD, ST BONIFACIUS, MN 55375-1315
(952) 467-1915
Mailing address
4246 SPRUCE RD, ST BONIFACIUS, MN 55375-1315
(952) 467-1915
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1745
MN
Other
Enumeration date
09/08/2005
Last updated
07/08/2007
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