Individual
ALISA ZAMUDIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
15621 NEATH DR, WOODBRIDGE, VA 22193-1042
(703) 718-2569
Mailing address
15621 NEATH DR, WOODBRIDGE, VA 22193-1042
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000737
VA
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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