Individual
NATHAN C MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(573) 233-5911
Mailing address
517 EYSIAN RD, CLARKSVILLE, TN 37040-6581
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2019020157
MO
2255A2300X
Athletic Trainer
3295
TN
2255A2300X
Athletic Trainer
Primary
AT2259
KY
Other
Enumeration date
04/26/2016
Last updated
10/08/2025
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