Andrey Balykov, ATC ATL
Specialist/Technologist, Athletic Trainer in Cape Coral, FL. Individual provider (NPI-1).
NPI number1043913908
StatusActive
Last updated in NPPESMar 27, 2023
Details
- NPI
- 1043913908
- Entity type
- Individual (NPI-1)
- Name
- Mr. Andrey Balykov
- Credential
- ATC ATL
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 22, 2023
- Certification date
- Mar 27, 2023
- Last updated
- Mar 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL4709 | FL | Yes |
Practice location
2204 Oasis Palm Cir Apt 405Cape Coral, FL 33991-3391
Phone 239-560-9185
Mailing address
8099 College PkwyFort Myers, FL 33919-5598
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