Individual
MR. NICHOLAS REED ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
24095 MARATHON ST, MISSION VIEJO, CA 92691-3803
(949) 278-2078
Mailing address
24095 MARATHON ST, MISSION VIEJO, CA 92691-3803
(949) 278-2078
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
E3104087
—
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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