Individual
MR. JUDSON FANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT, CSCS
Contact information
Practice address
421 N WOODLAND BLVD, UNIT 8317, DELAND, FL 32723-0001
(386) 822-7166
Mailing address
118 E VILLA CAPRI CIR, APT. A, DELAND, FL 32724-7866
(386) 848-6715
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1982
FL
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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