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Individual

JOANNA J BRAZZLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2920 W 135TH PL, GARDENA, CA 90249-2302
(310) 488-2178
Mailing address
2920 W 135TH PL, GARDENA, CA 90249-2302
(310) 488-2178

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
NA
Enumeration date
11/27/2019
Last updated
11/27/2019
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