Individual
MR. TODD PATRICK FAISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, ATC, LAT
Contact information
Practice address
1504 E. ITASCA AVE., LUBBOCK, TX 79403
(806) 766-1342
Mailing address
5311 31ST ST, LUBBOCK, TX 79407-3517
(806) 543-3917
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2427
TX
Other
Enumeration date
11/19/2011
Last updated
11/19/2011
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