Individual
JAIRO ANGEL DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13530 PIONEER ST, BONNER SPRINGS, KS 66012-9203
(913) 626-4253
Mailing address
13530 PIONEER ST, BONNER SPRINGS, KS 66012-9203
(913) 626-4253
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL5482
FL
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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