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Individual

MISS KATHERINE LOUISE EWALT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, ATC, HHP, NCTM

Contact information

Practice address
2650 TRUXTUN RD, SUITE #206, SAN DIEGO, CA 92106-6172
(619) 225-5762
Mailing address
2650 TRUXTUN RD, SUITE #206, SAN DIEGO, CA 92106-6172
(619) 225-5762

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
05/08/2006
Last updated
12/02/2011
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