Individual
MR. MANUEL DE ALBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT, ATC, CES
Contact information
Practice address
1123 COLEMAN AVE, SAN JOSE, CA 95110-1104
(408) 556-7761
Mailing address
3506 21ST ST, SUITE 202, LUBBOCK, TX 79410-1212
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000009968
—
2255A2300X
Athletic Trainer
AT5737
TX
Other
Enumeration date
01/26/2015
Last updated
01/19/2021
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