Individual
SARAH MUCCILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
30 LAUREL CANYON VILLAGE CIR APT 5203, CANTON, GA 30114-4606
(770) 842-7903
Mailing address
30 LAUREL CANYON VILLAGE CIR APT 5203, CANTON, GA 30114-4606
(770) 842-7903
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002771
GA
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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