Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gary David Premo, ATC

Individual provider Athletic Trainer · NPI 1710113105

Gary David Premo, ATC is an Athletic Trainer in Waupaca, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2009.

Licensed in
WI
In the registry since
2009
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

800 Riverside Dr
Waupaca, WI 54981-1943
Phone: (715) 258-1053
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 979-039 (WI)

Record details

NPI number1710113105
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorNo
NPI enumeratedMay 31, 2009
Last updated in NPPESMay 31, 2009
Mailing address208 W Wisconsin St, Weyauwega, WI 54983-9069

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