Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Peter O'Fallon Jr., ATC/LAT

Individual provider Athletic Trainer · NPI 1104200179

Mr. Peter O'Fallon Jr., ATC/LAT is an Athletic Trainer in Destin, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2015
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4421 Commons Dr E Suite-B 108
Destin, FL 32541-3484
Phone: (850) 460-2588
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AL 4145 (FL)

Record details

NPI number1104200179
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC/LAT
Sole proprietorYes
NPI enumeratedJuly 19, 2015
Last updated in NPPESJuly 19, 2015

Other providers in Destin