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Individual

NICOLE TOMLINSON VANNESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICENSED ATC

Contact information

Practice address
128 E PLAZA DR, MOORESVILLE, NC 28115-8000
(704) 663-3777
(704) 664-6615
Mailing address
128 E PLAZA DR, MOORESVILLE, NC 28115-8000
(704) 663-3777
(704) 664-6615

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0578
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0578
NC LICENSE
NC
01
974768
MEMBER
NC
Enumeration date
12/14/2006
Last updated
07/08/2007
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