Lisa Basarab
Specialist/Technologist, Athletic Trainer in Jacksonville, FL. Individual provider (NPI-1).
NPI number1972049500
StatusActive
Last updated in NPPESJan 6, 2017
Details
- NPI
- 1972049500
- Entity type
- Individual (NPI-1)
- Name
- Lisa Basarab
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 6, 2017
- Last updated
- Jan 6, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 001809 | NY | Yes |
Practice location
3451 Chrysler DrJacksonville, FL 32257-5405
Phone 904-631-2943
Mailing address
3451 Chrysler DrJacksonville, FL 32257-5405
Phone 904-631-2943
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