RYAN BLAKE PRIDEMORE

FORT BLISS, TX
NPI1033895602
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: TX  AT9424)
Enumeration Date2023-06-27
Last Update Date2023-06-27
Business Address
RYAN BLAKE PRIDEMORE LAT, ATC
18511 HIGHLANDER MEDICS ST
FORT BLISS, TX 79906-5327
Phone number: 423-312-1031
Mailing Address
RYAN BLAKE PRIDEMORE LAT, ATC
125 VAQUERO LN APT 176
EL PASO, TX 79912-6078
Phone number: 423-312-1031
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