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Individual

ANNELISE DANIELLE UNDERHILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT, NREMT

Contact information

Practice address
6501 CHESAPEAKE BLVD, NORFOLK, VA 23513-1998
(434) 534-2752
Mailing address
6501 CHESAPEAKE BLVD, NORFOLK, VA 23513-1998
(434) 534-2752

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003700
VA

Other

Enumeration date
03/15/2019
Last updated
12/27/2023
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