Individual
MR. DAVID BRIAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
27015 HIGHWAY 430 S, GREENWOOD, MS 38930-9421
(601) 664-8185
Mailing address
27015 HIGHWAY 430 S, GREENWOOD, MS 38930-9421
(601) 664-8185
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0357
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT0357
MS LIC. NUMBER
MS
Enumeration date
06/27/2006
Last updated
07/03/2012
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