Individual
ASHLEY MICHELLE GRODECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
151 RIBAULT ST, SPARTANBURG, SC 29302-2630
(864) 472-2836
Mailing address
151 RIBAULT ST, SPARTANBURG, SC 29302-2630
(864) 472-2836
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1706
SC
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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