Individual
MS. MINDY SUE WALLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
2125 NOLL DR, LANCASTER, PA 17603-7606
(717) 380-7000
Mailing address
61 BRENNER ST, MILLERSVILLE, PA 17551-1411
(717) 380-7000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004450
PA
Other
Enumeration date
05/20/2009
Last updated
10/30/2009
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