Individual
ALICE MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 N BELLFLOWER BLVD, LONG BEACH, CA 90840-0004
(563) 985-4111
Mailing address
1224 BENNETT AVE APT 1, LONG BEACH, CA 90804-4223
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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