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General NPI Number Information
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NPI Number | 1568923779
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Entity Type | Individual
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Provider Name | CAREY L MACDONALD ATC, ED.D
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Gender | Female
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 352 LAFAYETTE ST SALEM STATE UNIVERSITY
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City | SALEM
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State | MA
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Zip | 01970-0197
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Country | US
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Telephone | 978-542-7195
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Fax |
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Provider Business Mailing Address
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Address Line | 56A PICKMAN RD
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City | SALEM
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State | MA
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Zip | 01970-6761
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Country | US
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Telephone | 978-314-5951
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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 | MA
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