Individual
MISS MARISSA RADICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
17 PLEASANT AVE, BELLEVILLE, NJ 07109-1329
(201) 407-8928
Mailing address
17 PLEASANT AVE, BELLEVILLE, NJ 07109-1329
(201) 407-8928
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
070802212
NJ
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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