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General NPI Number Information
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NPI Number | 1265932354
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Entity Type | Individual
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Provider Name | JAMISON CARROLL HOLLOWELL LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 02/15/2018
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Provider Practice Location Address
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Address Line | 1350 PANTHER TRL SE
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City | LENOIR
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State | NC
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Zip | 28645-4736
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Country | US
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Telephone | 828-758-7376
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Fax | 828-758-9708
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Provider Business Mailing Address
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Address Line | 120 3RD ST SE
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City | HILDEBRAN
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State | NC
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Zip | 28637-8013
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Country | US
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Telephone |
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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 | LAT-3687
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License Number State | NC
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