Individual
ANDA UDRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-3966
(386) 226-6417
Mailing address
1200 FLORAL SPRINGS BLVD, #12104, PORT ORANGE, FL 32129-6800
(513) 739-6346
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3712
FL
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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