Individual
BETHANY GRACE DRUVENGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1301 COLLEGE AVE # 103, FREDERICKSBURG, VA 22401-5300
(540) 654-1874
Mailing address
1603 HUDGINS FARM CIR, FREDERICKSBURG, VA 22408-4191
(712) 260-0671
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001802
VA
Other
Enumeration date
02/26/2014
Last updated
08/19/2022
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