Individual
BRENNON KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CES
Contact information
Practice address
610 PINAL AVE, ORCUTT, CA 93455-5302
(425) 248-0315
Mailing address
339 JAYCEE DR, SAN LUIS OBISPO, CA 93405-1243
(425) 248-0315
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000013678
CA
Other
Enumeration date
07/01/2014
Last updated
07/01/2014
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