Individual
JORGE ISLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3609 SW DURHAM DR, DURHAM, NC 27707-6507
(919) 471-9622
Mailing address
5808 MORNING FOREST DR, RALEIGH, NC 27609-4120
(704) 957-6930
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-2638
NC
Other
Enumeration date
12/10/2013
Last updated
01/27/2023
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