Healthcare Provider Details

I. General information

NPI: 1992833420
Provider Name (Legal Business Name): ANTHONY HILL MS, ATC, PES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 11/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 E BULLDOG LN
FRESNO CA
93740-0001
US

IV. Provider business mailing address

1620 E BULLDOG LN
FRESNO CA
93740-0001
US

V. Phone/Fax

Practice location:
  • Phone: 559-278-2597
  • Fax: 559-278-8355
Mailing address:
  • Phone: 559-278-2597
  • Fax: 559-278-8355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT3805
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: