Individual
BRWYAN CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., ATC
Contact information
Practice address
2130 BRANNER AVE, JEFFERSON CITY, TN 37760-2210
(865) 471-3419
Mailing address
2130 BRANNER AVE, JEFFERSON CITY, TN 37760-2210
(865) 471-3419
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000001451
TN
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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