Individual
COURTNEY LYNN IVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
2699 LEE RD STE 100, WINTER PARK, FL 32789-1738
(407) 897-1363
Mailing address
2699 LEE RD STE 100, WINTER PARK, FL 32789-1738
(407) 897-1363
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3332
FL
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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