COLLIN BLAKE FREDERICK

GAINESVILLE, GA
NPI1770050536
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA  AT003432)
Enumeration Date2018-10-30
Last Update Date2018-10-30
Business Address
COLLIN BLAKE FREDERICK LAT, ATC
3005 SARDIS RD
GAINESVILLE, GA 30506-2232
Phone number: 912-294-7908
Mailing Address
COLLIN BLAKE FREDERICK LAT, ATC
76 HORSERANGE VISTA CT
CLEVELAND, GA 30528-2387
Phone number: 912-294-7908
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