Individual
KAITLYN ALEXANDRA MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204
(336) 516-7420
Mailing address
852 TIGER LN, CHARLOTTE, NC 28262-1124
(336) 516-7420
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT002545
GA
2255A2300X
Athletic Trainer
Primary
LAT-3110
NC
Other
Enumeration date
01/06/2016
Last updated
03/11/2019
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