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Individual

TIFFANY ELIZABETH DURAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, ATC

Contact information

Practice address
300 COLLEGE AVE, ORANGEBURG, SC 29115-4427
(803) 536-8625
(803) 533-3801
Mailing address
209 CABIN DR, IRMO, SC 29063-7876
(806) 789-9718

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1306
SC
2255A2300X
Athletic Trainer
Primary
2000005850
TX
2255A2300X
Athletic Trainer
AT4383
TX

Other

Enumeration date
01/09/2012
Last updated
01/19/2012
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