Individual
CANDELARIA NICOLLE EVERETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSAT
Contact information
Practice address
1 FORT JACKSON, COLUMBIA, SC 29207-5000
(361) 396-2928
Mailing address
1 FORT JACKSON, COLUMBIA, SC 29207-5000
(361) 396-2928
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATHL.A1.61322186
WA
Other
Enumeration date
01/06/2021
Last updated
06/13/2023
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