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1245655398
BETHANY GRACE DRUVENGA
FREDERICKSBURG, VA
NPI
1245655398
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA 0126001802)
Enumeration Date
2014-02-26
Last Update Date
2022-08-19
Business Address
BETHANY GRACE DRUVENGA LAT, ATC
1301 COLLEGE AVE # 103
FREDERICKSBURG, VA 22401-5300
Phone number: 540-654-1874
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Mailing Address
BETHANY GRACE DRUVENGA LAT, ATC
1603 HUDGINS FARM CIR
FREDERICKSBURG, VA 22408-4191
Phone number: 712-260-0671
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