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1629612072
IAN RODERICK MACPHERSON
GOLDEN VALLEY, MN
NPI
1629612072
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN 3160)
Enumeration Date
2019-10-29
Last Update Date
2019-10-29
Business Address
IAN RODERICK MACPHERSON ATC, LAT
4200 DAHLBERG DR STE 300
GOLDEN VALLEY, MN 55422-4841
Phone number: 952-512-5625
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Mailing Address
IAN RODERICK MACPHERSON ATC, LAT
937 CROMWELL AVE
SAINT PAUL, MN 55114-1121
Phone number: 651-890-2342
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