Individual
LESLIE TATUM CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1809 VICTORY AVE, WICHITA FALLS, TX 76301-6020
(408) 390-4494
Mailing address
1809 VICTORY AVE, WICHITA FALLS, TX 76301-6020
(408) 390-4494
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4849
TX
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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