Organization · NPI-2

Cdm Boxing Association

Health Educator · Houston, TX

NPI number1144597832

StatusActive

Last updated in NPPESSep 12, 2016

Details

NPI: 1144597832
Entity type: Organization (NPI-2)
Legal business name: Cdm Boxing Association
Organization subpart: No
Enumeration date: Nov 23, 2011
Last updated: Sep 12, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
174H00000X	Health Educator	–	–	Yes
224Y00000X	Clinical Exercise Physiologist	–	–
226300000X	Kinesiotherapist	–	–
225800000X	Recreation Therapist	–	–
2255A2300X	Specialist/Technologist, Athletic Trainer	–	–
2251S0007X	Physical Therapist, Sports	–	–

Practice location

1007 Stable Side Ct
Houston, TX 77073-6409

Phone 404-610-3046 · Fax 281-443-1432

Mailing address

1007 Stable Side Ct
Houston, TX 77073-6409

Phone 404-610-3046 · Fax 281-443-1432

Authorized official

Felicia Davis-Darthard
Administrator
4046103046

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