Melvin Enderes, ATC
Student in an Organized Health Care Education/Training Program in Brambleton, VA. Individual provider (NPI-1).
NPI number1710584792
StatusActive
Last updated in NPPESNov 27, 2023
Details
- NPI
- 1710584792
- Entity type
- Individual (NPI-1)
- Name
- Melvin Enderes
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 2, 2020
- Certification date
- Oct 2, 2020
- Last updated
- Nov 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | VA | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | VA |
Practice location
42678 Frontier DrBrambleton, VA 20148-7207
Phone 571-888-0852
Mailing address
42678 Frontier DrBrambleton, VA 20148-7207
Phone 571-888-0852
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