Individual
MS. LAURA MUDLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC, FD
Contact information
Practice address
20 MEMORIAL ST, EXETER, PA 18643-2659
(570) 655-2836
Mailing address
18 KENNEDY ST, PITTSTON, PA 18640-1820
(570) 814-5019
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT002370A
PA
Other
Enumeration date
03/20/2006
Last updated
12/01/2014
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