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General NPI Number Information
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NPI Number | 1598741308
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Entity Type | Individual
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Provider Name | MR. CARL JAMES BYRON III
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 50 SKYLINE ROAD EXT
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City | HICKORY
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State | NC
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Zip | 28601-7818
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Country | US
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Telephone | 828-238-8545
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Fax | 828-495-7873
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Provider Business Mailing Address
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Address Line | 50 SKYLINE ROAD EXT
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City | HICKORY
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State | NC
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Zip | 28601-7818
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Country | US
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Telephone | 828-238-8545
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Fax | 828-495-7873
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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 | 0371
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License Number State | NC
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