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1508417668
IVY VANESSA BANEZ
TUSCALOOSA, AL
NPI
1508417668
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2019-09-20
Last Update Date
2019-09-20
Business Address
IVY VANESSA BANEZ
504 UNIVERSITY BLVD
TUSCALOOSA, AL 35404
Phone number: 301-988-2762
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Mailing Address
IVY VANESSA BANEZ
504 UNIVERSITY BLVD
TUSCALOOSA, AL 35404
Phone number:
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