Individual
TRACI MICKEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
A.T.C.
Contact information
Practice address
3200 PLEASANT VALLEY BLVD, ALTOONA, PA 16602-4310
(814) 949-9500
(814) 949-9550
Mailing address
PO BOX 17, WARRIORS MARK, PA 16877-0017
(814) 632-7196
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003087
PA
Other
Enumeration date
01/03/2006
Last updated
07/08/2007
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