Kyauna Siu-Shu Southam, MAT, ATC
NPI #1083247621 in Ontario, California
Provider Information
- NPI Number
- 1083247621
- Entity Type
- Individual
- Name
- Kyauna Siu-Shu Southam, MAT, ATC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- MAT, ATC
- Enumeration Date
- Feb 21, 2020
- Last Updated
- May 16, 2023
Practice Location
- Address
- 3351 INLAND EMPIRE BLVD APT 17G
- City
- Ontario
- State
- California
- ZIP Code
- 91764-4863
- Phone
- (425) 241-7281
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
| Student in an Organized Health Care Education/Training Program |
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