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Organization

UNIVERSITY OF MARY HARDIN-BAYLOR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NELLASHA DAVIS ATC, LAT (ASSISTANT ATHLETIC TRAINER)
(254) 295-5034
Entity
Organization

Contact information

Practice address
900 COLLEGE ST # 8011, BELTON, TX 76513-2578
(254) 295-5034
Mailing address
900 COLLEGE ST # 8011, BELTON, TX 76513-2578
(254) 295-5034

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000022284
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2255A2300X
ATHLETIC TRAINER
TX
Enumeration date
08/10/2015
Last updated
08/10/2015
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