Individual
MRS. MARISA TAYLOR-EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,ATC
Contact information
Practice address
1409 S ARDILLA AVE, WEST COVINA, CA 91790-2407
(626) 806-2127
Mailing address
1409 S ARDILLA AVE, WEST COVINA, CA 91790-2407
(626) 806-2127
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
020102013
CA
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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