Individual
SAM FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
553 PEPEEKEO PL, HONOLULU, HI 96825-1121
(510) 499-1625
Mailing address
553 PEPEEKEO PL, HONOLULU, HI 96825-1121
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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