Individual
MIKKI LEANN OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LAT, ATC
Contact information
Practice address
1350 KING COLLEGE RD, BRISTOL, TN 37620-2632
(423) 652-6337
Mailing address
124 SJ OLIVER LOOP, ELIZABETHTON, TN 37643-4859
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126002098
VA
2255A2300X
Athletic Trainer
Primary
AT0000001702
TN
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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