Individual
SUSAN ELIZABETH MINIELLO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5400 RAMSEY ST, FAYETTEVILLE, NC 28311-1420
(910) 630-7597
Mailing address
5559 LINKWOOD DR, FAYETTEVILLE, NC 28311-0287
(910) 987-1696
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0892
NC
Other
Enumeration date
03/24/2006
Last updated
07/08/2007
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