Individual
EWELL R VERNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1029 OAK RIDGE RD, CANA, VA 24317-4160
(336) 648-5211
Mailing address
1029 OAK RIDGE RD, CANA, VA 24317-4160
(336) 648-5211
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001616
VA
2255A2300X
Athletic Trainer
LAT-2587
NC
Other
Enumeration date
04/24/2022
Last updated
04/24/2022
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