Individual
PAIGE PATINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
875 PERIMETER DR # MS 2401, MOSCOW, ID 83844-2401
(818) 421-0905
Mailing address
5223 PENNSYLVANIA AVE, LA CRESCENTA, CA 91214-1339
(818) 421-0905
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/01/2018
Last updated
06/01/2018
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