Individual
LISA BEATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
892 VAN HORN WAY, EL CAJON, CA 92019-3518
(619) 313-7587
Mailing address
892 VAN HORN WAY, EL CAJON, CA 92019-3518
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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