RYAN BLAKE PRIDEMORE

LAS CRUCES, NM
NPI1033895602
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NM  AT-2024-0006)
Additional Taxonomies2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX  AT9424)
Enumeration Date2023-06-27
Last Update Date2025-06-10
Business Address
RYAN BLAKE PRIDEMORE LAT, ATC
5700 MESA GRANDE DR
LAS CRUCES, NM 88011-6017
Phone number: 423-312-1031
Mailing Address
RYAN BLAKE PRIDEMORE LAT, ATC
3402 BIXLER DR APT 2202
LAS CRUCES, NM 88012-5114
Phone number: 423-312-1031