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Individual

KHYRA NATHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
402 E COLLEGE ST, BRIDGEWATER, VA 22812-1511
(540) 828-8000
Mailing address
15246 COACHMAN TER, WOODBRIDGE, VA 22191-3912

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
08/04/2017
Last updated
08/04/2017
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