Individual
MR. ELIAS LEVANWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., A.T.C., P.E.S.
Contact information
Practice address
11355 MOUNTAIN VIEW DR, APT 12, RANCHO CUCAMONGA, CA 91730-7221
(714) 478-2699
Mailing address
11355 MOUNTAIN VIEW DR, APT 12, RANCHO CUCAMONGA, CA 91730-7221
(714) 478-2699
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/07/2014
Last updated
02/07/2014
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