Individual provider · NPI-1

Noah Graves, LAT, ATC

Specialist/Technologist, Athletic Trainer · Jackson, TN

NPI number1740851625
StatusActive
Last updated in NPPESJul 1, 2021

Details

NPI
1740851625
Entity type
Individual (NPI-1)
Name
Mr. Noah Graves
Credential
LAT, ATC
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 1, 2021
Certification date
Jul 1, 2021
Last updated
Jul 1, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes

Practice location

1050 Union University Dr
Jackson, TN 38305-3656

Phone 731-267-0918

Mailing address

1050 Union University Dr
Jackson, TN 38305-3656

Phone 731-267-0918

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