Individual
ALBA ONTIVEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
8215 GROUSE RUN DR, LAS CRUCES, NM 88012-9277
(575) 649-6386
Mailing address
5271 CHENANGO DR, BATON ROUGE, LA 70808-4846
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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