| NPI | 1487062550 |
|---|---|
| Former Name | MALLORIE EASLICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: SC 1570) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NC LAT-2634) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2024-09-24 |