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Individual

MR. DANIEL CADAVID DUQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LAT, ATC

Contact information

Practice address
684 SIXES RD STE 130, HOLLY SPRINGS, GA 30115-8758
(770) 517-6636
Mailing address
704 VERNEER CT, WOODSTOCK, GA 30188-3620
(404) 729-3614

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002987
GA

Other

Enumeration date
06/01/2017
Last updated
06/01/2017
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