Individual
LAUREN MISHEL MINNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ATC
Contact information
Practice address
16500 MOJAVE DR, VICTORVILLE, CA 92395-3822
(760) 792-0861
Mailing address
12531 EL DORADO PL, VICTORVILLE, CA 92392-8063
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000023562
CA
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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