Individual
SUSAN DEVOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.S., A.T.,C.
Contact information
Practice address
4914 VIA LAPIZ, SAN DIEGO, CA 92122-3911
(619) 990-6971
Mailing address
4914 VIA LAPIZ, SAN DIEGO, CA 92122-3911
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
089802426
CA
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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