Individual
AVERI JO ALDERDYCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
136 HIGHLAND DR, RUSK, TX 75785-2408
(319) 480-4628
Mailing address
136 HIGHLAND DR, RUSK, TX 75785-2408
(319) 480-4628
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
050802329
—
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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