Individual
MR. BRENT ALAN RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., ATC, CSCS
Contact information
Practice address
24 WILLIAMS RD, NORTH GRAFTON, MA 01536-1238
(508) 839-0089
Mailing address
24 WILLIAMS RD, NORTH GRAFTON, MA 01536-1238
(508) 839-0089
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1183
MA
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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