Individual
MADISON POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
9229 ARNIE CT, MANASSAS PARK, VA 20111-3071
(703) 470-8818
Mailing address
9229 ARNIE CT, MANASSAS PARK, VA 20111-3071
(703) 368-5348
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003073
VA
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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