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General NPI Number Information
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NPI Number | 1831656743
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Entity Type | Individual
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Provider Name | KAYLA DAWN O'CONNELL DAT, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 2300 W INNES ST
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City | SALISBURY
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State | NC
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Zip | 28144-2488
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Country | US
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Telephone | 704-637-4350
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CASTLEWOOD DR APT 422
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City | SALISBURY
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State | NC
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Zip | 28147-1232
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Country | US
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Telephone | 240-575-4453
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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 | 6326
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License Number State | FL
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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 | A0001311
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | LAT-5538
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License Number State | NC
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