Individual
MR. FRED ALBERT BURNETT IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 UNF DR, JACKSONVILLE, FL 32224-7699
(904) 620-1500
Mailing address
5929 ORCHARD POND DR, FLEMING ISLAND, FL 32003-8308
(904) 278-3057
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2718
FL
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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