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General NPI Number Information
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NPI Number | 1841419256
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Entity Type | Individual
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Provider Name | CHAD J KRAWIEC ATC
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 2645 VIKINGS CIR STE 200
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City | EAGAN
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State | MN
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Zip | 55121-1963
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Country | US
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Telephone | 952-456-7650
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Fax |
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Provider Business Mailing Address
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Address Line | 13791 FIRELIGHT WAY
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City | APPLE VALLEY
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State | MN
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Zip | 55124-5047
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Country | US
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Telephone | 617-905-7329
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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 | 982
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2816
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License Number State | MN
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