MEDICARE: MISS LAURYN HUNTER MS, ATC, LAT, CES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	0126002664	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0126002664	OTHER	VA	VIRGINIA BOARD OF MEDICINE ATHLETIC TRAINING LICENSE NUMBER

General Provider Information

NPI Number	:	1992252381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LAURYN HUNTER MS, ATC, LAT, CES

Provider Business Mailing Address
First Line	:	895 UNIVERSITY BLVD
Second Line	:	MSC 4703
City	:	HARRISONBURG
State	:	VA
Zip	:	22807-1021
Country	:	US
Telephone Number	:	540-476-3347
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 UNIVERSITY BLVD
Second Line	:	MSC 4703
City	:	HARRISONBURG
State	:	VA
Zip	:	22807-1021
Country	:	US
Telephone Number	:	540-476-3347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2016
Last Update Date	:	09/02/2016

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