Justin Oglesby, ATC, LAT
Specialist/Technologist, Athletic Trainer in Fernandina Beach, FL. Individual provider (NPI-1).
NPI number1295123750
StatusActive
Last updated in NPPESJan 6, 2015
Details
- NPI
- 1295123750
- Entity type
- Individual (NPI-1)
- Name
- Mr. Justin Oglesby
- Credential
- ATC, LAT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 6, 2015
- Last updated
- Jan 6, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL3575 | FL | Yes |
Practice location
1409 Beech StFernandina Beach, FL 32034-3237
Phone 904-704-0465
Mailing address
1409 Beech StFernandina Beach, FL 32034-3237
Phone 904-704-0465
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