Provider Demographics
NPI:1427252063
Name:MESMAN, DAVID L (ATC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:MESMAN
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 1:875 W PECOS RD
Mailing Address - Street 2:APT 1120
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6898
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:875 W PECOS RD
Practice Address - Street 2:APT 1120
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-6898
Practice Address - Country:US
Practice Address - Phone:928-812-1961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer