Individual
ROBERT GAISFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MMEDSC, ATC
Contact information
Practice address
1 OLYMPIC PLAZA, SPORTS MEDICINE/OLYMPIC TRAINING CENTER, COLORADO SPRINGS, CO 80920
(719) 866-4554
Mailing address
1 OLYMPIC PLAZA, SPORTS MEDICINE/OLYMPIC TRAINING CENTER, COLORADO SPRINGS, CO 80920
(719) 866-4554
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000006551
NATABOC
—
01
—
AT.0001221
COLORADO REGISTRATION
CO
Enumeration date
10/09/2014
Last updated
10/09/2014
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