Individual
CARLY BUDIAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2130 BRANNER AVE, JEFFERSON CITY, TN 37760-2210
(262) 565-7517
Mailing address
1646 RUSSELL AVE, JEFFERSON CITY, TN 37760-2204
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 0000001940
TN
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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