Individual
IVAN DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1304 ALABAMA AVE, LYNN HAVEN, FL 32444-2535
(850) 716-2547
Mailing address
1304 ALABAMA AVE, LYNN HAVEN, FL 32444-2535
(850) 716-2547
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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