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Individual

BRYCE B GAINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
10753 FALLS RD, SUITE 215, LUTHERVILLE, MD 21093-4535
(410) 847-3736
(410) 583-2855
Mailing address
10753 FALLS RD, SUITE 215, LUTHERVILLE, MD 21093-4535
(410) 847-3736
(410) 583-2855

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0000371
MD
2255A2300X
Athletic Trainer
J30000362
DE
2255A2300X
Athletic Trainer
RT004939
PA

Other

Enumeration date
01/15/2015
Last updated
01/15/2015
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