| NPI | 1023000981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON CARROLL Head Athletic Trainer 870-972-3342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2020-08-22 |