Individual
TENNILLE MORALES GREGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4064 POSTAL DRIVE, ROANOKE, VA 24018
(540) 731-2436
Mailing address
4064 POSTAL DRIVE, ROANOKE, VA 24018
(540) 731-2436
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000930
VA
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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