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1457873051
SAMUEL WICHAEL
ORLANDO, FL
NPI
1457873051
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL 3692)
Enumeration Date
2017-07-14
Last Update Date
2017-07-14
Business Address
SAMUEL WICHAEL LAT, ATC, CES
4422 KNIGHTS VICTORY WAY
ORLANDO, FL 32816-8019
Phone number: 407-823-4303
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Mailing Address
SAMUEL WICHAEL LAT, ATC, CES
3326 MISSION BAY BLVD APT 130
ORLANDO, FL 32817-1997
Phone number: 303-217-1789
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