Healthcare Provider Details

I. General information

NPI: 1528212396
Provider Name (Legal Business Name): LAURA ANN HARTMAN M.S., ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW SUITE 215
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

106 IRVING ST NW SUITE 215
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-4236
  • Fax: 202-877-6602
Mailing address:
  • Phone: 202-877-4236
  • Fax: 202-877-6602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: