Individual
MIKAELA ANN POORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATS
Contact information
Practice address
REC HALL , BURROWES RD, UNIVERSITY PARK, PA 16802
(814) 865-5284
Mailing address
2267 MUNSTER RD, LILLY, PA 15938-6201
(814) 381-4646
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
09/04/2020
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