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1780044776
NICHOLAS ANTONELLI
FORT BRAGG, NC
NPI
1780044776
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36002358A)
Enumeration Date
2016-03-03
Last Update Date
2022-07-29
Business Address
NICHOLAS ANTONELLI ATC
2817 REILLY RD WAMC CREDENTIALING
FORT BRAGG, NC 28310
Phone number: 517-896-0261
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Mailing Address
NICHOLAS ANTONELLI ATC
2817 REILLY ST
FORT BRAGG, NC 28310-7324
Phone number:
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