Organization
SPECIALTY ATHLETIC TRAINING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN LOCKARD CSCS, CSPS (FOUNDER)
(503) 863-0512
Entity
Organization
Contact information
Practice address
501 SE ELLSWORTH RD, VANCOUVER, WA 98664-5101
(503) 863-0512
Mailing address
9208 NE HIGHWAY 99 STE 107-117, VANCOUVER, WA 98665-8986
(503) 863-0512
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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