Individual
MISS BRIANNA KIERRA BLACKSHEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
402 E COLLEGE ST, BRIDGEWATER, VA 22812-1599
(540) 828-8000
Mailing address
402 E COLLEGE ST, BRIDGEWATER, VA 22812-1599
(540) 828-8000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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