Individual
MR. PAUL G RUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2900 SUTTON RD, VIENNA, VA 22181-6109
(703) 319-2833
(703) 319-2713
Mailing address
11044 GRANBY CT, RESTON, VA 20191-5021
(703) 716-5778
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000151
VA
Other
Enumeration date
07/15/2006
Last updated
07/08/2007
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