NPI 1053864504

South Dakota State University

Organisation Athletic Trainer Brookings, SD

Practice location

Address: 2820 Hper Ctr, Brookings, SD 57007-1497
Phone: (605) 688-4003

Authorised official

Name: Owen Stanley
Title: Assistant Athletic Director
Phone: (605) 688-5299

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 0521 (SD)

Other Specialist/Technologist providers in South Dakota →

Registry record

NPI: 1053864504
Entity type: Organization
NPI issued: 2 Aug 2016
Record last updated: 2 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.