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Individual

MR. LANCE WAYNE BERNARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, LAT, ATC, OTC

Contact information

Practice address
2901 ACME BRICK PLZ, FORT WORTH, TX 76109-4124
(817) 529-1900
(817) 529-1910
Mailing address
7925 BELLA FLORA DR, FORT WORTH, TX 76126-6070
(817) 487-1466

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
010402106
TX
2255A2300X
Athletic Trainer

Other

Enumeration date
08/16/2017
Last updated
08/16/2017
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