Individual
EDMOND CHRISTOPHER INA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1901 MOONEY ST, WINSTON SALEM, NC 27103-3032
(336) 713-5230
Mailing address
1901 MOONEY ST, WINSTON SALEM, NC 27103-3032
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1710
NC
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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