Individual
MALISSA TICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 SPRING GARDEN ST, GREENSBORO, NC 27412-5015
(336) 334-5000
Mailing address
PO BOX 26170, GREENSBORO, NC 27402-6170
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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