Individual
ANDREW SUPERAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
315 W 14TH ST, DAVIS, CA 95616-1914
(530) 757-5400
Mailing address
871 DONOVAN CT, DAVIS, CA 95618-4819
(530) 304-9812
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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