Provider Demographics
NPI:1659581056
Name:WESTERENG, STEVEN BRADLEY (ATC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BRADLEY
Last Name:WESTERENG
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5255 8TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-1880
Mailing Address - Country:US
Mailing Address - Phone:701-746-4147
Mailing Address - Fax:701-777-2536
Practice Address - Street 1:2751 2ND AVE N HYSLOP SPORTS CENTER RM 115
Practice Address - Street 2:UNIVERSITY OF NORTH DAKOTA
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-9013
Practice Address - Country:US
Practice Address - Phone:701-777-3886
Practice Address - Fax:701-777-2536
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND204-992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer