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General NPI Number Information
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NPI Number | 1346883568
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Entity Type | Individual
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Provider Name | CARL NEWTON ATC
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Gender | Male
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Dates
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Enumeration Date | 10/21/2019
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 9360 SPARTA PIKE
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City | WATERTOWN
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State | TN
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Zip | 37184-1428
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Country | US
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Telephone | 615-237-3434
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Fax | 615-237-3030
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Provider Business Mailing Address
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Address Line | 1411 W BADDOUR PKWY
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City | LEBANON
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State | TN
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Zip | 37087-2513
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Country | US
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Telephone | 615-443-6099
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Fax | 615-443-6094
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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 | 1071
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License Number State | TN
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