Individual
ALEX NORTHRUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
654 HIGHLAND FARMS CIR, GAMBRILLS, MD 21054-1065
(410) 349-7992
Mailing address
654 HIGHLAND FARMS CIR, GAMBRILLS, MD 21054-1065
(410) 349-7992
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
SC
Other
Enumeration date
08/28/2015
Last updated
08/28/2015
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