Individual
TIFFANY MASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, ATC
Contact information
Practice address
14830 VAN NESS AVE, GARDENA, CA 90249-3718
(310) 324-6675
Mailing address
PO BOX 14482, TORRANCE, CA 90503-8482
(310) 324-6675
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
010502101
CA
Other
Enumeration date
05/01/2007
Last updated
05/16/2012
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