Individual
MARIO SEROUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4112 KIMBERS RD, HARRISBURG, PA 17112-2876
(717) 585-2188
Mailing address
4112 KIMBERS RD, HARRISBURG, PA 17112-2876
(717) 585-2188
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9402089388
—
PA
Enumeration date
03/28/2019
Last updated
06/11/2019
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