Organization
DAWG MENTALITY SPORTS PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISRAEL WILLIAMS CSCS (EXECUTIVE MANAGER)
(919) 698-7479
Entity
Organization
Contact information
Practice address
829 GOLDEN HORSESHOE LN, SANFORD, NC 27330-7311
(919) 698-7479
Mailing address
829 GOLDEN HORSESHOE LN, SANFORD, NC 27330-7311
(919) 698-7479
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30649936
NCDMV
NC
Enumeration date
08/17/2021
Last updated
08/17/2021
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