Individual
MR. ANTHONI AUSTIN WEDDERBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1401 EDWARDS MILL RD, RALEIGH, NC 27607-0718
(919) 834-1625
(919) 834-9771
Mailing address
5501 THUNDERIDGE DR, RALEIGH, NC 27610-5163
(919) 780-4758
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-1496
NC
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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