Individual
MARY PESICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1000 W AUSTIN BLVD, NEVADA, MO 64772-2763
(417) 667-8181
Mailing address
1000 W AUSTIN BLVD, NEVADA, MO 64772-2763
(216) 509-6218
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2018026629
MO
Other
Enumeration date
08/28/2018
Last updated
03/01/2021
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