Individual
DYLAN SHELBY FRAZIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
567 N 5TH ST, TERRE HAUTE, IN 47809-3358
(719) 214-8521
Mailing address
2232 NORMAN LN, PUEBLO, CO 81005-3358
(719) 214-8521
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
01/30/2020
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