Individual
MARINA VANDERSLICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 WHEAT ST, COLUMBIA, SC 29201-4347
(479) 419-0827
Mailing address
903 SYCAMORE TRCE, LOWELL, AR 72745-9064
(479) 419-0827
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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