Colin Heraty

Individual provider Active NPI Athletic Trainer · Wabasha, MN

NPI 1003516642 · NPPES record last updated Mar 2, 2023

Key facts

NPI
1003516642
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
406 Main St E
Wabasha, MN 55981-1427
Phone
(507) 858-5523
NPI assigned
Mar 2, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

406 Main St E
Wabasha, MN 55981-1427

Mailing address

406 Main St E
Wabasha, MN 55981-1427
Phone (507) 858-5523

Other providers in Wabasha, MN

All providers in Wabasha, MN · Athletic Trainer in Minnesota

Sources for this page

Verify at the official NPI Registry.