Dustin Wayne Green, ATC, LAT
NPI #1205460458 in Alexandria, Minnesota
Provider Information
- NPI Number
- 1205460458
- Entity Type
- Individual
- Name
- Dustin Wayne Green, ATC, LAT
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC, LAT
- Enumeration Date
- Feb 26, 2020
- Last Updated
- Feb 26, 2020
Practice Location
- Address
- 111 17TH AVE E STE 101
- City
- Alexandria
- State
- Minnesota
- ZIP Code
- 56308-3734
- Phone
- (320) 762-1144
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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