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General NPI Number Information
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NPI Number | 1275049207
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Entity Type | Individual
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Provider Name | HOLLY LORD ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 2690 KELLY BLVD
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City | CLAREMONT
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State | NC
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Zip | 28610-7427
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Country | US
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Telephone | 828-459-8006
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 21ST AVE NE APT D
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City | HICKORY
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State | NC
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Zip | 28601-1663
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Country | US
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Telephone | 828-234-8721
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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-3076
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License Number State | NC
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