Individual
TIFFANY NICOLE HAZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9055 BALBOA AVE, SAN DIEGO, CA 92123-1509
(913) 827-7130
Mailing address
3900 LOMALAND DR, SAN DIEGO, CA 92106-2810
(913) 827-7130
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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