Individual
DANIEL CORDOBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
59 HAWTHORNE ST APT 2, CHELSEA, MA 02150-3411
(203) 273-7571
Mailing address
59 HAWTHORNE ST APT 2, CHELSEA, MA 02150-3411
(203) 273-7571
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MA
Other
Enumeration date
12/08/2016
Last updated
12/10/2016
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