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Individual
JUSTIN TRAYLOR
Active
Individual
JUSTIN TRAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000006889
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000006889
BOARD OF CERTIFICATION
—
Enumeration date
08/16/2017
Last updated
08/16/2017
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