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Individual

SAMMANTHA BROCKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, ATC

Contact information

Practice address
2130 FULTON ST, SAN FRANCISCO, CA 94117-1080
(916) 390-7638
Mailing address
2130 FULTON ST, SAN FRANCISCO, CA 94117-1080

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000016054
CA

Other

Enumeration date
06/18/2017
Last updated
06/18/2017
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