Individual provider · NPI-1

John F Banaszak, A.T.C.

Specialist/Technologist, Athletic Trainer · Mount Vernon, WA

NPI number1962576736
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1962576736
Entity type
Individual (NPI-1)
Name
Mr. John F Banaszak
Credential
A.T.C.
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 20, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

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

Practice location

314 N 9th St
Mount Vernon, WA 98273-3327

Phone 360-428-6100

Mailing address

Po Box 598
La Conner, WA 98257-0598

Phone 360-466-9982

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Specialist/Technologist, Athletic Trainer providers in Mount Vernon, WA