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Individual

LORA SERAPHIN FITZGERALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, ATC

Contact information

Practice address
1651 W ROSEDALE ST, STE. 200, FT WORTH, TX 76104-7437
(817) 335-4316
(817) 336-2504
Mailing address
5524 LA BANDERA TRL, BENBROOK, TX 76126-1843
(337) 212-3849

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050202041
NATABOC
Enumeration date
08/14/2006
Last updated
09/08/2014
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