Individual
JOURNEY PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT, LAT, ATC
Contact information
Practice address
5601 19TH ST, LUBBOCK, TX 79407-2099
(828) 545-4911
Mailing address
4110 17TH ST APT 504, LUBBOCK, TX 79416-6003
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
TX
Other
Enumeration date
08/08/2025
Last updated
08/08/2025
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