Individual
SAMANTHA MIHALIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
501 E MAIN ST, RAYMOND, MS 39154-9700
(601) 857-5261
Mailing address
PO BOX 1100, RAYMOND, MS 39154-1100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0903
MS
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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