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Individual

MIRANDA MERRILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1620 E BULLDOG LANE M/S OF 87, FRESNO, CA 93740-0001
(559) 278-2643
Mailing address
382 NORTH MCKELVY AVENUE, #239, CLOVIS, CA 93611
(425) 293-4904

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
07/23/2021
Last updated
07/23/2021
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