Individual provider · NPI-1
Kelly Daniels, LAT ATC
Specialist/Technologist, Athletic Trainer · Elizabeth City, NC
NPI number1689123473
StatusActive
Last updated in NPPESSep 22, 2016
Details
- NPI
- 1689123473
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kelly Daniels
- Credential
- LAT ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 22, 2016
- Last updated
- Sep 22, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2966 | NC | Yes |
Practice location
1134 N Road StBldg 7
Elizabeth City, NC 27909-3365
Phone 252-384-2360 · Fax 252-384-2359
Mailing address
1134 N Road StBldg 7
Elizabeth City, NC 27909-3365
Phone 252-384-2360 · Fax 252-384-2359
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