Individual
MARIAH BERNANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7730 COMPTON CT, CHARLOTTE, NC 28270-9548
(704) 604-7719
Mailing address
7730 COMPTON CT, CHARLOTTE, NC 28270-9548
(704) 604-7719
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000034855866
NC
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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