Sean Darrell Degerstrom ATC, CSCS

NPI 1790712727 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1790712727
Gender Male
Enumeration Date 06/26/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
310 E MARKET ST
TIFFIN OH, 44883-2434, US
Phone (419) 448-2154
Fax
Business Location
59 E MARKET ST
TIFFIN OH, 44883-2831, US
Phone (419) 443-8164
Fax
Toxanomy
Taxonomy Code 2255A2300X
License State Ohio
License Number 002298
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According to our database, Sean Darrell Degerstrom ATC, CSCS NPI is 1790712727, taxonomy code is 2255A2300X and license number is 002298, license state is located at Ohio. Sean Darrell Degerstrom ATC, CSCS physically located at 310 E Market St, Tiffin OH, 44883-2434. NPI Number Sean Darrell Degerstrom ATC, CSCS has the Individual type.

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1790712727 NPI number is provided on an as is basis without warranty of any kind. 1790712727 is maintained by the National Plan & Provider Enumeration System. The contents of Sean Darrell Degerstrom ATC, CSCS are for informational purposes only.