Individual provider · Type 1 NPI
Derek Gustovich
Student in an Organized Health Care Education/Training Program · Mineral Ridge, OH
NPI number
1689221004
Active
Practice location
1465 Morris St
Mineral Ridge, OH 44440-9707
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Other student in an organized health care education/training program providers in Mineral Ridge
About NPI 1689221004
Derek Gustovich's National Provider Identifier is 1689221004, issued on Aug 20, 2019. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Mineral Ridge, OH. The record was last updated on Aug 20, 2019.