Individual
REYNALDO BENNETT IGLIANE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS, EMT-B
Contact information
Practice address
5532 MYRA AVE, CYPRESS, CA 90630-4507
(480) 298-0908
Mailing address
5532 MYRA AVE, CYPRESS, CA 90630-4507
(480) 298-0908
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
11/19/2009
Last updated
11/19/2009
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