MARK R. ICENOGLE (AT-C) – Athletic Trainer, NPI 1306800610
Athletic Trainer
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MARK R. ICENOGLE (AT-C)
758, Old Norcross Road, Lawrenceville, Gwinnett County, Georgia, 30046, United States
LAWRENCEVILLE, GA 300453385
Phone: (678) 985-7190
Fax: (678) 985-7158
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30045)
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