Individual
KALEB FARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5714 BEVERLY DR, INDIAN TRAIL, NC 28079-8539
(704) 249-0104
(980) 343-1475
Mailing address
5714 BEVERLY DR, INDIAN TRAIL, NC 28079-8539
(704) 249-0104
(980) 343-1475
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2226
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000012180
BOC
—
01
—
2226
NCBATE
NC
Enumeration date
12/11/2013
Last updated
12/11/2013
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