Individual
THOMAS M HALLORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
8918 BLAKENEY PROFESSIONAL DR STE 120, CHARLOTTE, NC 28277-6692
(704) 900-8960
Mailing address
5115 PARK RD APT 357, CHARLOTTE, NC 28209-3880
(704) 962-0197
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-3637
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAT-3637
NCBATE
NC
Enumeration date
02/05/2018
Last updated
02/05/2018
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