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General NPI Number Information
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NPI Number | 1225680549
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Entity Type | Individual
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Provider Name | KEVIN CARNALL ATC
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Gender | Male
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 800 MAIN ST
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City | GARDENDALE
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State | AL
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Zip | 35071-2634
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Country | US
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Telephone | 205-379-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 640 ROSEBURY RD
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City | HELENA
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State | AL
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Zip | 35080-6814
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Country | US
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Telephone | 251-272-6305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 965
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License Number State | AL
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