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1710483326
MILDRED VANNICOLA
PHILADELPHIA, PA
NPI
1710483326
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: PA RT004865)
Enumeration Date
2018-04-03
Last Update Date
2018-04-03
Business Address
MILDRED VANNICOLA MS, ATC
3401 N BROAD ST
PHILADELPHIA, PA 19140-5103
Phone number: 215-707-2111
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Mailing Address
MILDRED VANNICOLA MS, ATC
1806 GREEN ST APT 110
PHILADELPHIA, PA 19130-3971
Phone number:
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