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Individual

JOHN DEBILZAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
474 OSPREY CIR, LEXINGTON, KY 40503-4356
(859) 420-4135
Mailing address
474 OSPREY CIR, LEXINGTON, KY 40503-4356
(859) 420-4135

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
089
KY

Other

Enumeration date
06/29/2014
Last updated
06/29/2014
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