Individual
MR. KYLE GARBER BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
120 WHITFORD DR, YOH FOOTBALL CENTER, DURHAM, NC 27708-9982
(919) 681-1422
(919) 684-2102
Mailing address
120 WHITFORD DR, DURHAM, NC 27708-9982
(919) 681-1422
(919) 684-2102
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1600
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070402702
NATA BOC NUMBER
VA
Enumeration date
04/04/2006
Last updated
02/14/2015
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