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General NPI Number Information
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NPI Number | 1821530270
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Entity Type | Individual
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Provider Name | TROY DANIEL HOLLAND MAT, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 7942 CALIFORNIA AVE BAY 3
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-5515
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Country | US
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Telephone | 270-798-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 727 ACORN DR
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City | CLARKSVILLE
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State | TN
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Zip | 37043-2613
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Country | US
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Telephone | 909-731-5940
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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 | 2573
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License Number State | TN
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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 | 2000023670
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License Number State |
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Taxonomy #3
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 729339
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License Number State | TX
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