Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARK R. ICENOGLE, AT-C
ActiveMARK R. ICENOGLE, AT-C is a Athletic Trainer healthcare provider located in LAWRENCEVILLE, Georgia. NPI 1306800610 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · LAWRENCEVILLE, GA
Registration Details
- NPI Number
- 1306800610
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 13, 2006 (20.29738711571 yrs)
- Last Updated
- Apr 8, 2008
- License
-
AT001236 (GA)
Practice Information
- Address
-
758 OLD NORCROSS RDLAWRENCEVILLE, GA, 300453385Browse GA providers · Browse ZIP 30045
- Phone
- 6789857190
- Fax
- 6789857158
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in LAWRENCEVILLE, GA
| Name | Credential | NPI |
|---|---|---|
| JON S. STEFFEY | AT-C | 1700840733 |
| MRS. COLLEEN YVONNE BUTLER | MS,ATC, LAT | 1801836960 |
| KEVIN PILAND | ATC | 1760588131 |
| CHRISTOPHER JOHNSON | ATC | 1487748810 |
| EMILY MILLER | ATC | 1902999634 |
| COURTNEY ENGLAND | ATC | 1801980487 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.