Individual
MR. TERRY E WALBURN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSED., ATC, VATL
Contact information
Practice address
409 SUPPLEJACK CT, CHESAPEAKE, VA 23320-9233
(757) 548-5815
Mailing address
409 SUPPLEJACK CT, CHESAPEAKE, VA 23320-9233
(757) 548-5815
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000110
VA
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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