Organization
FRAZIER ATHLETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA BOONE (ASSISTANT)
(951) 858-9858
Entity
Organization
Contact information
Practice address
9919 CANOGA AVE UNIT 109, CHATSWORTH, CA 91311-3002
(951) 858-9858
Mailing address
9919 CANOGA AVE UNIT 109, CHATSWORTH, CA 91311-3002
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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