Lamar Richard Innes, ATC Valid NPI

Individual provider · Athletic Trainer · Douglas, AZ

NPI

1457752115

Type

Individual (Type 1)

Primary specialty

Athletic Trainer (Specialist/Technologist)

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

2255A2300X

License number

1203 (AZ)

Sex

Male

Sole proprietor

Yes

Enumerated

2014-09-11

Last updated

2014-09-11