Individual
MERCEDES INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
833 HUFFS CHURCH ROAD, ALBURTIS, PA 18011
(610) 845-8767
Mailing address
833 HUFFS CHURCH ROAD, ALBURTIS, PA 18011
(610) 845-8767
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT006113
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000020722
BOC
PA
Enumeration date
03/17/2016
Last updated
03/17/2016
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