Organization
SOUTHEASTERN SPORTSMEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AL WALLACE (CEO)
(828) 274-4555
Entity
Organization
Contact information
Practice address
23 TURTLE CREEK DR, ASHEVILLE, NC 28803-3152
(828) 274-4555
Mailing address
81 EMMA DR, WAYNESVILLE, NC 28786-9006
(828) 452-4476
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0739
NC
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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