Individual
MICHAEL CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8170 DENVER RD, WAVERLY, OH 45690-9535
(740) 708-4178
Mailing address
8170 DENVER RD, WAVERLY, OH 45690-9535
(740) 708-4178
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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