Individual
COURTNEY MUSTARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
635 JEFFERSON ST, FAIRBORN, OH 45324-5420
(937) 242-8935
Mailing address
635 JEFFERSON ST, FAIRBORN, OH 45324-5420
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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