NPI 1225801459

Logan Jesperson

Practitioner Athletic Trainer Saint Cloud, MN

Practice location

Address: 3541 17th Ave S, Saint Cloud, MN 56301-9664
Phone: (320) 412-0695

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1225801459
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Oct 2023
Record last updated: 31 Oct 2023

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.