Individual
ALYSSAH ADRIANA DURAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3575 KEITH ST NW, STE 205, CLEVELAND, TN 37312-4324
(423) 559-0444
(423) 559-0103
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2013
TN
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/20/2015
Last updated
04/29/2016
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