MARK R. ICENOGLE

LAWRENCEVILLE, GA
NPI1306800610
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA  AT001236)
Enumeration Date2006-04-13
Last Update Date2008-04-08
Business Address
-- MARK R. ICENOGLE AT-C
758 OLD NORCROSS RD
LAWRENCEVILLE, GA 30045-3385
Phone number: 678-985-7190
Mailing Address
-- MARK R. ICENOGLE AT-C
758 OLD NORCROSS RD
LAWRENCEVILLE, GA 30045-3385
Phone number: 678-985-7190
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