Provider Demographics
NPI:1457388795
Name:ESLINGER, DUSTIN ELMER (MA R/ATC)
Entity type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:ELMER
Last Name:ESLINGER
Suffix:
Gender:M
Credentials:MA R/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 119TH AVE NW APT 35
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-6721
Mailing Address - Country:US
Mailing Address - Phone:586-354-1520
Mailing Address - Fax:
Practice Address - Street 1:3220 BRIDGE ST NW STE 111
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:MN
Practice Address - Zip Code:55070-8631
Practice Address - Country:US
Practice Address - Phone:763-753-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN18762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer