Individual
VICTORIA THIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
97 MORRISON AVE, STATEN ISLAND, NY 10310-2942
(347) 951-1739
Mailing address
97 MORRISON AVE, STATEN ISLAND, NY 10310-2942
(347) 951-1739
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1374285191
NY
Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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