Individual
MISS SALLY ANN MARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED, ATL, ATC
Contact information
Practice address
9414 ATLEE STATION ROAD, MECHANICSVILLE, VA 23116-2600
(804) 723-2100
Mailing address
714 LAKE CAROLINE DRIVE, RUTHER GLEN, VA 22546-5304
(804) 761-8688
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000210
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126000210
LICENSE TO PRACTICE
VA
Enumeration date
03/27/2007
Last updated
04/15/2017
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