Individual provider · NPI-1

Davidson Cielo Canaveral, ATC

Specialist/Technologist, Athletic Trainer · Henderson, NV

NPI number1093495301
StatusActive
Last updated in NPPESJul 20, 2023

Details

NPI
1093495301
Entity type
Individual (NPI-1)
Name
Davidson Cielo Canaveral
Credential
ATC
Sex
Male
Sole proprietor
No
Enumeration date
Jul 20, 2023
Certification date
Jul 20, 2023
Last updated
Jul 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes

Practice location

5880 Boulder Falls St Apt 2181
Henderson, NV 89011-4971

Phone 808-687-0196

Mailing address

5880 Boulder Falls St Apt 2181
Henderson, NV 89011-4971

Phone 808-687-0196

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