Sophia Nicole Brown, ATC

Individual provider Active NPI Athletic Trainer · Adairsville, GA

NPI 1003176504 · NPPES record last updated May 18, 2012

Key facts

NPI
1003176504
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
AT001779 (GA)
Practice address
7423 Adairsville Hwy
Adairsville, GA 30103-2014
Phone
(770) 773-9315
Fax
(770) 773-9717
NPI assigned
May 18, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AT001779GAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT001779 GA Yes

Addresses

Primary practice location

7423 Adairsville Hwy
Adairsville, GA 30103-2014

Mailing address

PO Box 949
Rome, GA 30162-0949
Phone (706) 236-2774

Other providers in Adairsville, GA

All providers in Adairsville, GA · Athletic Trainer in Georgia

Sources for this page

Verify at the official NPI Registry.