Provider Demographics
NPI:1649676966
Name:REDMAN, DAVID (ATC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:REDMAN
Suffix:
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 1:6730 4TH AVE
Mailing Address - Street 2:APT. 931
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2678
Mailing Address - Country:US
Mailing Address - Phone:469-964-3416
Mailing Address - Fax:
Practice Address - Street 1:6000 J ST
Practice Address - Street 2:ATHLETICS DEPT
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-2605
Practice Address - Country:US
Practice Address - Phone:469-964-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer