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General NPI Number Information
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NPI Number | 1972671345
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Entity Type | Individual
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Provider Name | CONSTANCE GEORGE ATC
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15744 GOLDENWEST ST
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3103
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Country | US
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Telephone | 714-895-8248
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Fax | 714-895-8320
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Provider Business Mailing Address
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Address Line | 14202 FLOWER ST APT T
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4777
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Country | US
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Telephone | 714-534-8480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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