Individual
COURTNEY DIMITRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 13TH ST E APT 641, TUSCALOOSA, AL 35401-3396
(630) 962-9770
Mailing address
2100 S NEW RD APT 332, WACO, TX 76711-1816
(630) 962-9770
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7994
TX
Other
Enumeration date
11/13/2018
Last updated
11/13/2019
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