NPI | 1124378070 |
---|---|
Former Name | DANIELLE L CHESNUT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL3337) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: GA AT001913) |
2255A2300X Specialist/Technologist Athletic Trainer (Licence: AL 1344) | |
Enumeration Date | 2012-09-18 |
Last Update Date | 2021-02-17 |