Individual
THEO DECOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
28826 BAILEY RANCH RD, HAYWARD, CA 94542-2169
(510) 901-9216
Mailing address
28826 BAILEY RANCH RD, HAYWARD, CA 94542-2169
(510) 901-9216
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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