Individual
ELIZABETH CONQUEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
311 RIVERSIDE DR APT 217, HOLLY HILL, FL 32117-3767
(386) 295-2669
Mailing address
311 RIVERSIDE DR APT 217, HOLLY HILL, FL 32117-3767
(386) 295-2669
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2898
FL
Other
Enumeration date
03/28/2013
Last updated
03/28/2013
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