Judson Fann, MS, ATC, LAT, CSCS
Specialist/Technologist, Athletic Trainer in Deland, FL. Individual provider (NPI-1).
NPI number1982806519
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1982806519
- Entity type
- Individual (NPI-1)
- Name
- Mr. Judson Fann
- Credential
- MS, ATC, LAT, CSCS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 5, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL1982 | FL | Yes |
Practice location
421 N Woodland BlvdUnit 8317
Deland, FL 32723-0001
Phone 386-822-7166
Mailing address
118 E Villa Capri CirApt. A
Deland, FL 32724-7866
Phone 386-848-6715
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