Nathan Black, MAT, LAT, ATC
Specialist/Technologist, Athletic Trainer in Birmingham, AL. Individual provider (NPI-1).
NPI number1295392629
StatusActive
Last updated in NPPESJan 5, 2023
Details
- NPI
- 1295392629
- Entity type
- Individual (NPI-1)
- Name
- Nathan Black
- Credential
- MAT, LAT, ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 21, 2019
- Certification date
- Jan 5, 2023
- Last updated
- Jan 5, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2612 | AL | Yes |
Practice location
800 Lakeshore DrBirmingham, AL 35229-0001
Phone 478-254-3656
Mailing address
800 Lakeshore DrBirmingham, AL 35229-0001
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