| NPI | 1558485896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MATTHEW EGGEN Assistant Athletic Trainer 805-756-5491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |