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General NPI Number Information
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NPI Number | 1376929653
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Entity Type | Individual
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Provider Name | MELISSA LINSTROM ATC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 1002 CANCER CENTER DR
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City | LUBBOCK
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State | TX
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Zip | 79430-0001
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Country | US
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Telephone | 818-518-5680
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Fax |
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Provider Business Mailing Address
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Address Line | 223 INDIANA AVE APT 3313
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City | LUBBOCK
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State | TX
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Zip | 79415-3370
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Country | US
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Telephone | 818-518-5680
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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 | AT6308
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License Number State | TX
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