Individual
NICOLE MUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4900 SUGAR RIDGE RD, PEMBERVILLE, OH 43450-8701
(419) 833-3611
Mailing address
5854 YERMO DR APT Q2, TOLEDO, OH 43613-1641
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003790
OH
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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