Individual
MR. WESLEY R. MALLICONE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
1871 OLD MAIN DR, SHIPPENSBURG, PA 17257-2200
(717) 477-1749
(717) 477-4070
Mailing address
323 FORT ST, APT.# 6, SHIPPENSBURG, PA 17257-1455
(717) 816-3355
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT002265A
PA
Other
Enumeration date
09/29/2005
Last updated
07/08/2007
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