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General NPI Number Information
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NPI Number | 1437644937
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Entity Type | Individual
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Provider Name | KOLTEN ELIZABETH ADAMS ATC
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Gender | Female
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 4400 S MLK JR PARKWAY
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City | BEAUMONT
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State | TX
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Zip | 77705
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Country | US
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Telephone | 409-880-2359
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Fax |
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Provider Business Mailing Address
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Address Line | 512 BUTTERNUT RD
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City | GRANDVIEW
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State | WA
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Zip | 98930-9317
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Country | US
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Telephone | 509-830-0475
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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 |
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License Number State |
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