Individual
KIMBERLY MICHELLE LANCASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5022 OLD GODSEY LN, STE 3, HIXSON, TN 37343-6600
(423) 870-3573
(423) 870-3574
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 362-8684
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2099
TN
2255A2300X
Athletic Trainer
AT002750
GA
Other
Enumeration date
07/13/2016
Last updated
08/01/2016
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