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NPI 1740307701

NPI 1740307701 : TROYCE SOLLEY ATC, LAT : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1740307701
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    Entity Type          |    Individual 
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    Provider Name        |    TROYCE SOLLEY ATC, LAT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/23/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3001 S CONGRESS AVE 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78704-6425
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    Country              |    US
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    Telephone            |    512-416-5802
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7707 S I H 35 APT 524 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78744-5521
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    Country              |    US
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    Telephone            |    512-426-1717
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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       |    AT3046
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    License Number State |    TX
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