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1811032873
JUSTIN LEE SWAGGERT
MINNEAPOLIS, MN
NPI
1811032873
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2007-02-20
Last Update Date
2007-07-08
Business Address
Mr. JUSTIN LEE SWAGGERT ATC
516 15TH AVE SE
MINNEAPOLIS, MN 55455-0130
Phone number: 612-625-0649
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Mailing Address
Mr. JUSTIN LEE SWAGGERT ATC
2545 ALDRICH AVE S
MINNEAPOLIS, MN 55405-2925
Phone number: 651-334-9128
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