Individual
DANIEL MUMMERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
4701 N CENTRAL AVE, PHOENIX, AZ 85012-1723
(602) 264-5291
Mailing address
4701 N CENTRAL AVE, PHOENIX, AZ 85012-1723
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0975
AZ
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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