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Individual

MR. BRIAN MYCHAL ENRIQUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S., ATC

Contact information

Practice address
21817 FIGUEROA ST, UNIT 12, CARSON, CA 90745-1919
(310) 735-5238
Mailing address
21817 FIGUEROA ST, UNIT 12, CARSON, CA 90745-1919
(310) 735-5238

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000009460

Other

Enumeration date
10/08/2012
Last updated
10/08/2012
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