Individual
MANDIE MICHAEL LOZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
662 MCDONOUGH BLVD SE, ATLANTA, GA 30315-4439
(732) 615-7564
Mailing address
662 MCDONOUGH BLVD SE, ATLANTA, GA 30315-4439
(732) 615-7564
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002233
GA
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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