Individual
ELIZABETH HAZEBROEK IRVING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
309 KERNEWAY, BALTIMORE, MD 21212-4714
(443) 462-8157
Mailing address
309 KERNEWAY, BALTIMORE, MD 21212-4714
(443) 462-8157
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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