Individual
RUSSELL GARCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
4319 CREEKSIDE LOOP, WILLIAMSBURG, VA 23188-2698
(540) 848-2784
Mailing address
4319 CREEKSIDE LOOP, WILLIAMSBURG, VA 23188-2698
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003470
VA
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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