Individual
GUSTAVO ALEJANDRO CANALS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC
Contact information
Practice address
13104 TALL SHADOWS LN APT A, FAIRFAX, VA 22033-5004
(571) 215-1880
Mailing address
13104 TALL SHADOWS LN APT A, FAIRFAX, VA 22033-5004
(571) 215-1880
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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