Individual
MYCHELLE LYNN BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1300 WHEAT ST, COLUMBIA, SC 29208-0001
(803) 777-5261
Mailing address
1050 SOUTHERN DR APT 1806, COLUMBIA, SC 29201-5644
(915) 319-0503
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
SC
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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