Individual
CANDACE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,ATC
Contact information
Practice address
5450 MONTGOMERY SQUARE DR, APT G, KETTERING, OH 45440-2952
(937) 367-3200
Mailing address
5450 MONTGOMERY SQUARE DR, APT G, KETTERING, OH 45440-2952
(937) 367-3200
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.003574
OH
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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