GARY DAVID PREMO ATC
NPI 1710113105
Specialist/Technologist - Athletic Trainer in Waupaca, WI

Q: What is Gary Premo's NPI number?

The NPI number for Gary Premo is 1710113105. It was assigned to this individual provider in the NPPES registry on May 31, 2009.

Q: What is Gary Premo's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Q: When was this NPI record last updated?

The NPPES record for Gary Premo was last updated on May 31, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 31, 2009

800 RIVERSIDE DR, WAUPACA, WI 54981(715) 258-1053 Get Directions Write a Review

NPPES record last updated: May 31, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Gary David Premo Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY DAVID PREMO ATC (NPI 1710113105) is an individual athletic trainer provider in Waupaca, Wisconsin, licensed in Wisconsin (979-039) and active in the NPI registry since May 2009.

NPPES Registry Identity

NPI1710113105

Entity TypeIndividualMale

Primary Taxonomy2255A2300X

Provider Legal NameGARY DAVID PREMOCredential: ATC

Location Address800 RIVERSIDE DRWaupaca, WI 54981-1943

Mailing Address208 W Wisconsin StWeyauwega, WI 54983-9069 · (715) 570-5889

Phone(715) 258-1053

Sole ProprietorNo

Enumeration DateMay 31, 2009

✔ NPI 1710113105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2255A2300X

License✔ Licensed in WI · 979-039

Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

800 RIVERSIDE DR, Waupaca, WI 54981

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THEDACARE MEDICAL CENTER - WAUPACA, INC.

General Acute Care Hospital (Critical Access)