Individual
CAITLYN HARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1276 GILBREATH DR, JOHNSON CITY, TN 37614-6503
(217) 248-0466
Mailing address
PO BOX 70707, JOHNSON CITY, TN 37614-1710
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
ATHLETIC TRAINING
—
Enumeration date
11/11/2019
Last updated
11/11/2019
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