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Individual

KAYLA GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1051 SOUTHERN DR, COLUMBIA, SC 29201-5189
(909) 733-7723
Mailing address
425 PEPPER TREE DR, BREA, CA 92821
(909) 733-7723

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
SC

Other

Enumeration date
04/30/2014
Last updated
07/17/2015
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