Individual
JUSTIN-CASEY ROCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT ATC
Contact information
Practice address
1303 MCCULLOUGH AVE, SAN ANTONIO, TX 78212-5609
(726) 666-0262
Mailing address
7719 WESTLYN DR, SAN ANTONIO, TX 78227-2633
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7430
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7430
BLUECROSS BLUESHIELD
TX
Enumeration date
07/21/2021
Last updated
07/21/2021
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