Steven James Ahlvers, ATC
Individual provider Active NPI Athletic Trainer · Edina, MN
NPI 1104890904 · NPPES record last updated Oct 10, 2012
Key facts
- NPI
- 1104890904
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1419 (MN)
- Practice address
- 4010 W 65TH St
Edina, MN 55435-1706 - Phone
- (651) 210-8696
- NPI assigned
- Feb 16, 2006
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1419 | MN | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1419 | MN | Yes |
Addresses
Primary practice location
4010 W 65TH St
Edina, MN 55435-1706
Mailing address
9815 Upper 205TH St W
Lakeville, MN 55044-5934
Phone (651) 210-8696
Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.