Individual
ZACHARY D. FANDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1791 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5648
(928) 855-4248
Mailing address
1791 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5648
(928) 855-4248
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1448
AZ
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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