| NPI | 1326011834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA K BARE GROUNDS Owner & Medical Coordinator 850-582-2067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-2444) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL678) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004435) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 1443) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001047) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NV 0506267) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2015-01-13 |