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Individual provider · Athletic Trainer · Blacksburg, VA

NPI
1104373463
Type
Individual (Type 1)
Primary specialty
Athletic Trainer (Specialist/Technologist)
Specialty group
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy code
2255A2300X
License number
0126003265 (VA)
Sex
Female
Sole proprietor
Yes
Enumerated
2016-09-04
Last updated
2019-08-14
Practice location
21 Beamer Way
Blacksburg, VA 24061
(407) 415-1736

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