Individual
MRS. MARTHA SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
2620 BLANDING BLVD, SUITE 28, MIDDLEBURG, FL 32068-5185
(904) 282-8640
(904) 282-8696
Mailing address
1011 ORANGEWOOD RD, JACKSONVILLE, FL 32259-3160
(904) 287-4649
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1270
FL
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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