Individual
MISS MARY ROSE TOVORNIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
STONY BROOK UNIVERSITY, INDOOR SPORTS COMPLEX, STONY BROOK, NY 11794-0001
(631) 632-4084
(631) 632-3231
Mailing address
100 MARINERS WAY APT 202, PORT JEFFERSON, NY 11777-1838
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003628
PA
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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