Individual
DUSTIN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4301 WILSON ST, FORT SILL, OK 73503-4472
(276) 768-6907
Mailing address
4301 WILSON S, FORT SILL, OK 73503
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002398
GA
Other
Enumeration date
02/08/2016
Last updated
02/08/2016
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