Individual
MARSHELLE WICEVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2 MEDICAL PARK RD, COLUMBIA, SC 29203-6808
(843) 847-0472
Mailing address
2 MEDICAL PARK RD, COLUMBIA, SC 29203-6808
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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