| NPI | 1760956197 |
|---|---|
| Other Name | JOHN ELMER ANDERSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RTO000239) |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2020-02-05 |