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Individual

MR. HUNTER LEE DURVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
7276 MERLE SMITH LN, MECHANICSVILLE, VA 23111-5029
(804) 730-1389
Mailing address
7276 MERLE SMITH LN, MECHANICSVILLE, VA 23111-5029
(804) 730-1389

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000045
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0126000045
ATHLETIC TRAINER LICENSE
VA
Enumeration date
04/19/2007
Last updated
07/08/2007
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