Individual
MISS ANDREA MELICHAREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1300 EAGLE RD, ST DAVIDS, PA 19087-3617
(610) 225-5461
Mailing address
825 MANSFIELD RD W, BORDENTOWN, NJ 08505-4512
(609) 731-6202
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003700
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RT003700
AT LICENSE
PA
Enumeration date
11/20/2006
Last updated
07/08/2007
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