Healthcare Provider Details

I. General information

NPI: 1487714978
Provider Name (Legal Business Name): LAURIE FINCHER ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UWA STATION 14
LIVINGSTON AL
35470
US

IV. Provider business mailing address

UWA STATION 14
LIVINGSTON AL
35470
US

V. Phone/Fax

Practice location:
  • Phone: 205-652-3455
  • Fax:
Mailing address:
  • Phone: 205-652-3455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number906
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: