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Individual

MARY E. SULT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC, ROT

Contact information

Practice address
860 LAKECREST AVE APT 2B, HIGH POINT, NC 27265-2683
(336) 906-0324
Mailing address
860 LAKECREST AVE APT 2B, HIGH POINT, NC 27265-2683
(336) 906-0324

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1628
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030802029
BOARD OF CERTIFICATION, INC
01
091817050
AMERICAN SOCIETY OF ORTHOPEDIC PROFESSIONALS
01
1628
NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS
NC
Enumeration date
09/16/2008
Last updated
04/20/2018
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