Individual
MARISKA CHARLENE TRUESDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T., CFM
Contact information
Practice address
3909 OLEANDER DR, SUITE D, WILMINGTON, NC 28403-6730
(910) 619-4803
(910) 395-5773
Mailing address
1205 PINE VALLEY DR, WILMINGTON, NC 28409-2596
(910) 619-4803
(910) 395-5773
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
—
—
225000000X
Orthotic Fitter
—
—
225100000X
Physical Therapist
4979
NC
Other
Enumeration date
05/09/2007
Last updated
09/13/2013
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