Healthcare Provider Details
I. General information
NPI: 1053348540
Provider Name (Legal Business Name): DEBORAH ROBINSON MACLEAN A.T.,C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
HEALTHWORKS/THE COCA-COLA COMPANY ONE COCA-COLA PLAZA - HMC
ATLANTA GA
30313
US
IV. Provider business mailing address
HEALTHWORKS/THE COCA-COLA COMPANY ONE COCA-COLA PLAZA - HMC
ATLANTA GA
30313
US
V. Phone/Fax
- Phone: 404-676-2841
- Fax: 404-598-2841
- Phone: 404-676-2841
- Fax: 404-598-2841
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2255A2300X |
| Taxonomy | Athletic Trainer |
| License Number | 0049 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: