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Individual

MIKAYLA CORIN TALAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1904 ENGLISH OAK CT, VIRGINIA BEACH, VA 23453-7088
(757) 580-2020
Mailing address
1904 ENGLISH OAK CT, VIRGINIA BEACH, VA 23453-7088
(757) 580-2020

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
200003962
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
10/05/2019
Last updated
07/22/2020
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