Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. PETER O'FALLON JR., ATC/LAT
Active Sole ProprietorMR. PETER O'FALLON JR., ATC/LAT is a Athletic Trainer healthcare provider located in DESTIN, Florida. NPI 1104200179 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · DESTIN, FL
Registration Details
- NPI Number
- 1104200179
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 19, 2015 (11.084421471446 yrs)
- Last Updated
- Jul 19, 2015
- License
-
AL 4145 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4421 COMMONS DR ESUITE-B 108DESTIN, FL, 325413484Browse FL providers · Browse ZIP 32541
- Phone
- 8504602588
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.