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Individual

CIERRA CHANEL BOOTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, ATC

Contact information

Practice address
1 HIGH SCHOOL HILL RD, ATASCADERO, CA 93422-4189
(805) 550-7444
Mailing address
7820 SAN MARCOS RD, ATASCADERO, CA 93422-4060
(702) 747-1807

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
01/31/2017
Last updated
01/31/2017
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