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1831125103
LEE CHARLES DISON
JACKSONVILLE, FL
NPI
1831125103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: FL AL1248)
Enumeration Date
2006-06-25
Last Update Date
2007-07-08
Business Address
LEE CHARLES DISON ATC/LAT
6464 SILVER GLEN DR
JACKSONVILLE, FL 32258-5134
Phone number: 904-268-1007
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Mailing Address
LEE CHARLES DISON ATC/LAT
6464 SILVER GLEN DR
JACKSONVILLE, FL 32258-5134
Phone number: 904-268-1007
Copy
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