NPI 1083149231

Glenn Edgerton, EDDLAT

Practitioner Athletic Trainer Flagstaff, AZ

Practice location

Address: 1705 N San Francisco St, Flagstaff, AZ 86001-1348
Phone: (928) 523-6837
Mailing address: PO Box 15094, Flagstaff, AZ 86011-0543

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 1079 (AZ)

Other Specialist/Technologist providers in Arizona →

Registry record

NPI: 1083149231
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Apr 2017
Record last updated: 25 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.