Individual
TRACY ELIZABETH AYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11435 VENICE BLVD, LOS ANGELES, CA 90066-4028
(310) 869-5842
Mailing address
11435 VENICE BLVD, LOS ANGELES, CA 90066-4028
(310) 869-5842
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
BOC243906
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BOC243906
BOARD OF CERTIFICATON
CA
Enumeration date
03/07/2018
Last updated
03/07/2018
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