Individual
MISS NICOLE MUMAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
56 WAVERLY AVE, DAYTON, OH 45405-2227
(937) 277-6812
Mailing address
56 WAVERLY AVE, DAYTON, OH 45405-2227
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003868
OH
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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