Provider Demographics
NPI:1225650492
Name:CEDERLUND, DONALD III (ATC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:CEDERLUND
Suffix:III
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N JORDAN ST APT 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-5528
Mailing Address - Country:US
Mailing Address - Phone:703-989-9791
Mailing Address - Fax:
Practice Address - Street 1:302 N JORDAN ST APT 101
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-5528
Practice Address - Country:US
Practice Address - Phone:703-989-9791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer