Individual
DANIEL L SEVERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1807 BLAIR CT, HINESVILLE, GA 31313-9482
(912) 980-3247
Mailing address
1807 BLAIR CT, HINESVILLE, GA 31313-9482
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001266
GA
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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