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General NPI Number Information
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NPI Number | 1568422244
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Entity Type | Individual
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Provider Name | AMY GILBERTSON ATC
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Gender | Female
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Dates
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Enumeration Date | 03/25/2006
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Last Update Date | 03/31/2015
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Provider Practice Location Address
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Address Line | 2115 SUMMIT AVE STE 5003
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City | SAINT PAUL
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State | MN
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Zip | 55105-1048
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Country | US
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Telephone | 952-300-0697
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Fax | 651-962-5981
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Provider Business Mailing Address
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Address Line | 12944 2ND AVE S
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City | BURNSVILLE
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State | MN
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Zip | 55337-3503
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Country | US
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Telephone | 715-523-1626
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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