Individual
MISA TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1815 WELLS ST, LAS CRUCES, NM 88003-1304
(575) 415-5394
Mailing address
4260 NORTHRISE DR APT 1623, LAS CRUCES, NM 88011-7316
(575) 415-5394
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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