Individual
MS. RENEE CANDACE MICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT, MS, PES
Contact information
Practice address
89 MESSENGER RD APT C2, COOKEVILLE, TN 38506-5781
(910) 995-5262
Mailing address
89 MESSENGER RD APT C2, COOKEVILLE, TN 38506-5781
(910) 995-5262
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1777
TN
Other
Enumeration date
05/03/2020
Last updated
05/03/2020
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