Individual
SIERRA NIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC LAT
Contact information
Practice address
4254 TIMBER TRACE RD, LOGANVILLE, GA 30052-3562
(404) 312-8781
Mailing address
4254 TIMBER TRACE RD, LOGANVILLE, GA 30052-3562
(404) 312-8781
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002569
GA
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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