Individual
AUSTIN BUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 WHIPORWILL DR, PORT ORANGE, FL 32127-5969
(386) 589-5573
Mailing address
820 WHIPORWILL DR, PORT ORANGE, FL 32127-5969
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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