Individual
CLARICE TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
116 WALNUT ST, ATHENS, PA 18810-1723
(570) 888-0057
(570) 888-0058
Mailing address
509 ALDRICH RD, MILLERTON, PA 16936-9496
(570) 404-6391
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002738-1
NY
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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