NPI 1093495301

Davidson Cielo Canaveral, ATC

Practitioner Athletic Trainer Henderson, NV

Practice location

Address: 5880 Boulder Falls St APT 2181, Henderson, NV 89011-4971
Phone: (808) 687-0196

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

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Registry record

NPI: 1093495301
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Jul 2023
Record last updated: 20 Jul 2023

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.