Individual
ANDAVEA NITA ALBERTA ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
897 BAZEL RD, HARRIMAN, TN 37748-5803
(404) 405-5206
Mailing address
897 BAZEL RD, HARRIMAN, TN 37748-5803
(404) 405-5206
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MO
Other
Enumeration date
09/08/2018
Last updated
11/13/2018
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