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NPI Code Detail

MEDICARE: JUSTIN PLECKO ATC

MEDICARE: JUSTIN PLECKO ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1487534970
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN PLECKO ATC
Provider Business Mailing Address
First Line : 22371 BRETT TRL
Second Line :
City : ROGERS
State : MN
Zip : 55374-4545
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2520 PILOT KNOB RD
Second Line :
City : MENDOTA HEIGHTS
State : MN
Zip : 55120-1137
Country : US
Telephone Number : 651-224-8264
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2025
Last Update Date : 09/04/2025

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Directions to “ JUSTIN PLECKO ATC” Practice Location

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