Individual
DAVID MICHAEL FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
19455 DEERFIELD AVE STE 312, LANSDOWNE, VA 20176-8102
(703) 729-5010
Mailing address
3421 DOE RUN CT, HERNDON, VA 20171-3358
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002757
VA
Other
Enumeration date
07/18/2017
Last updated
08/30/2017
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