Individual
CARLI VINING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
3370 MJ TAYLOR RD, ADEL, GA 31620-7139
(229) 561-2716
Mailing address
3370 MJ TAYLOR RD, ADEL, GA 31620-7139
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/08/2019
Last updated
07/01/2020
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