Individual
MISS DEVON NICHOLE WAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, ATC, CHES, CWHC
Contact information
Practice address
2212 E 4TH ST STE 301, SANTA ANA, CA 92705-3873
(714) 571-7727
(714) 744-0136
Mailing address
715 W SOUTH ST, ANAHEIM, CA 92805-4414
(714) 624-6601
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
20602
CA
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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