Individual
MICHELLE NICOLE VANDE BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, A.T.,C., CSCS
Contact information
Practice address
601 EAST MAIN ST., ESS ATHLETICS, COLLEGEVILLE, PA 19426-1000
(610) 409-3000
(610) 409-3776
Mailing address
1111 CATHEDRAL LN, NORRISTOWN, PA 19403-5151
(610) 630-1284
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT002373A
PA
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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