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1275192338
JAMES BRIAN SOUTHARD
PHOENIX, AZ
NPI
1275192338
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: AZ 000355)
Enumeration Date
2019-06-11
Last Update Date
2024-05-20
Business Address
JAMES BRIAN SOUTHARD ATC
10712 W CAMELBACK RD
PHOENIX, AZ 85037-5072
Phone number: 520-249-8337
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Mailing Address
JAMES BRIAN SOUTHARD ATC
10712 W CAMELBACK RD
PHOENIX, AZ 85037-5072
Phone number: 520-249-8337
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