Individual
MARIO ANTONIO LOZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1247 GANNET LN, PATTERSON, CA 95363-9071
(209) 531-5095
Mailing address
1247 GANNET LN, PATTERSON, CA 95363-9071
(209) 531-5095
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
BOC297662
CA
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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