Individual
BRYCE MICELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
45 MADISON DR, READING, PA 19606-8804
(610) 823-8681
Mailing address
45 MADISON DR, READING, PA 19606-8804
(610) 823-8681
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007925
PA
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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