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NPI Code Detail

MEDICARE: PROF. TODD NEUHARTH ATC

MEDICARE: PROF. TODD NEUHARTH 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 Trainer104-0000106VT

General Provider Information

NPI Number : 1205820859
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. TODD NEUHARTH ATC
Provider Business Mailing Address
First Line : 1200 KENWOOD AVE
Second Line : COLLEGE OF ST. SCHOLASTICA
City : DULUTH
State : MN
Zip : 55811-4199
Country : US
Telephone Number : 603-290-1703
Fax Number :
Provider Business Practice Location Address
First Line : 1200 KENWOOD AVE
Second Line : COLLEGE OF ST. SCHOLASTICA
City : DULUTH
State : MN
Zip : 55811-4199
Country : US
Telephone Number : 603-290-1703
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 04/19/2016

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Directions to “ PROF. TODD NEUHARTH ATC” Practice Location

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