Individual
MARSHALL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS LAT ATC
Contact information
Practice address
101 GOPHER BOULEVARD, GRAND PRAIRIE, TX 75051
(972) 809-5762
Mailing address
1204 GENESIS DR, MANSFIELD, TX 76063-8650
(214) 912-4130
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2069
TX
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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