Individual
MR. JOSIAH ALEXANDER MAULTSBY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
3100 DURALEIGH RD, SUITE 100, RALEIGH, NC 27612-8106
(919) 866-4207
Mailing address
3100 DURALEIGH RD, SUITE 100, RALEIGH, NC 27612-8106
(919) 866-4207
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1577
NC
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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