Individual
MRS. MARTHA SIMMS MIKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, ATC, CSCS
Contact information
Practice address
1028 AUGUSTA FARMS RD, STUARTS DRAFT, VA 24477-3200
(540) 886-8500
Mailing address
45 FLORY AVE, STUARTS DRAFT, VA 24477-2944
(540) 337-2638
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000100
VA
Other
Enumeration date
07/04/2006
Last updated
07/08/2007
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