Individual
MR. ROBERT FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, M.S.
Contact information
Practice address
150 VALPARAISO AVE, ATHERTON, CA 94027-4402
(650) 473-4035
Mailing address
150 VALPARAISO AVE, ATHERTON, CA 94027-4402
(650) 473-4035
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096.002601
IL
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
05/12/2008
Last updated
12/15/2016
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