Individual
MR. ANDREY BALYKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC ATL
Contact information
Practice address
2204 OASIS PALM CIR APT 405, CAPE CORAL, FL 33991-3391
(239) 560-9185
Mailing address
8099 COLLEGE PKWY, FORT MYERS, FL 33919-5598
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4709
FL
Other
Enumeration date
03/22/2023
Last updated
03/27/2023
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