Individual
MR. PAUL R MUSGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC/L, CSCS,
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(931) 920-4644
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
101
TN
2255A2300X
Athletic Trainer
AT366
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000090496
NATIONAL CERTIFICATION
—
01
—
101
STATE OF TN MEDICAL BOARDS
TN
Enumeration date
11/06/2006
Last updated
12/16/2025
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