Individual
MS. MARY AGNES PIECHOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.,C
Contact information
Practice address
POCONO MOUNTAIN WEST HIGHSCHOOL, HC 89 BOX 2002 ROUTE 940, POCONO SUMMITT, PA., PA 18346
(570) 839-7121
(570) 839-0974
Mailing address
RR 3 BOX 3196, BLUE RIDGE ROAD, SAYLORSBURG, PA 18353-9631
(610) 381-7246
(570) 839-0974
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT000295A
PA
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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