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Individual

MS. SIOBHAN E FAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED., AT, ATC, CSCS

Contact information

Practice address
5911 IVY RIDGE RD, DAYTON, OH 45431-2913
(937) 602-0580
Mailing address
5911 IVY RIDGE RD, DAYTON, OH 45431-2913

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.002301
OH

Other

Enumeration date
07/30/2013
Last updated
07/30/2013
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