Individual
DAIBELIZ TAMARA VEGA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPAS, PA-C, ATC
Contact information
Practice address
611 W FRANCIS ST STE 200, NORTH PLATTE, NE 69101-0614
(308) 568-3500
Mailing address
611 W FRANCIS ST STE 200, NORTH PLATTE, NE 69101-0614
(308) 568-3500
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2000016608
FL
363A00000X
Physician Assistant
Primary
PA.0006419
CO
Other
Enumeration date
06/23/2014
Last updated
03/31/2021
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