Individual
JAMES BRIAN SOUTHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
10712 W CAMELBACK RD, PHOENIX, AZ 85037-5072
(520) 249-8337
Mailing address
10712 W CAMELBACK RD, PHOENIX, AZ 85037-5072
(520) 249-8337
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000355
AZ
Other
Enumeration date
06/11/2019
Last updated
05/20/2024
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