Individual
HEATHER POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4900 FRONTAGE RD S, LAKELAND, FL 33815-3193
(863) 284-2073
Mailing address
5701 BAHIA DEL MAR CIR APT 208, ST PETERSBURG, FL 33715-2356
(813) 810-1342
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
4294
FL
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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