Individual
KELVIN MIGUEL MARADIAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11165 KIMBERLY AVE, MONTCLAIR, CA 91763-6331
(626) 364-6686
Mailing address
11165 KIMBERLY AVE, MONTCLAIR, CA 91763-6331
(626) 364-6686
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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