Individual
ALEXANDRA MISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
423 MAIN ST, WILBRAHAM, MA 01095-1699
(413) 596-6811
Mailing address
17 JONQUIL DR, SPRINGFIELD, MA 01119-2712
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2507
MA
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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