Individual
MISS HEATHER NICOLE LEMASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
1525 HERBERT ST, PORT ORANGE, FL 32129-6106
(386) 756-0424
Mailing address
1525 HERBERT ST, PORT ORANGE, FL 32129-6106
(386) 756-0424
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3525
FL
Other
Enumeration date
12/02/2011
Last updated
06/04/2013
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