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1376255075
DIANA MARIBEL PONCE
LOS ANGELES, CA
NPI
1376255075
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2022-12-14
Last Update Date
2022-12-14
Business Address
DIANA MARIBEL PONCE
2602 VALLEJO ST
LOS ANGELES, CA 90031-3032
Phone number: 323-332-8149
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Mailing Address
DIANA MARIBEL PONCE
2602 VALLEJO ST
LOS ANGELES, CA 90031-3032
Phone number: 323-332-8149
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