DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GARY DAVID PREMO, ATC

Active

GARY DAVID PREMO, ATC is a Athletic Trainer healthcare provider located in WAUPACA, Wisconsin. NPI 1710113105 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · WAUPACA, WI

Registration Details

NPI Number
1710113105
Provider Type
Individual
Gender
Male
NPI Issued
May 31, 2009 (17.171082108482 yrs)
Last Updated
May 31, 2009
License
979-039 (WI)

Practice Information

Address
800 RIVERSIDE DR
WAUPACA, WI, 549811943
Browse WI providers · Browse ZIP 54981
Phone
7152581053
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in WAUPACA, WI

Name Credential NPI
CASSANDRA GLODOWSKI MS,LAT,ATC 1558814244
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.