ANNE MARIE MICINSKI

SOUTH BEND, IN
NPI1912065848
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36000188A)
Enumeration Date2006-12-04
Last Update Date2007-07-08
Business Address
Ms. ANNE MARIE MICINSKI ATC, LAT
1005 N HICKORY RD
SOUTH BEND, IN 46615-3723
Phone number: 574-233-5754
Mailing Address
Ms. ANNE MARIE MICINSKI ATC, LAT
3718 FERN HILL DR
MISHAWAKA, IN 46544-6265
Phone number: 574-257-8512
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