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General NPI Number Information
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NPI Number | 1588037626
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Entity Type | Individual
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Provider Name | CAITLYN MCLEOD MSCN, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 130 WINTER LN
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City | POUNDING MILL
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State | VA
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Zip | 24637-1101
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Country | US
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Telephone | 276-971-4905
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Fax |
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Provider Business Mailing Address
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Address Line | 130 WINTER LN
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City | POUNDING MILL
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State | VA
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Zip | 24637-1101
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Country | US
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Telephone |
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 311908
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License Number State | TN
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