John K Carollo, MS, LAT, ATC
Specialist/Technologist, Athletic Trainer in San Antonio, TX. Individual provider (NPI-1).
NPI number1841235546
StatusActive
Last updated in NPPESOct 1, 2023
Details
- NPI
- 1841235546
- Entity type
- Individual (NPI-1)
- Name
- Mr. John K Carollo
- Credential
- MS, LAT, ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 17, 2006
- Certification date
- Oct 1, 2023
- Last updated
- Oct 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT1929 | TX | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT-1425 | OH |
Practice location
8431 Fredericksburg Rd Fl 5San Antonio, TX 78229-3392
Phone 210-845-6458
Mailing address
8431 Fredericksburg Rd Fl 5San Antonio, TX 78229-3392
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