Healthcare Provider Details

I. General information

NPI: 1568580447
Provider Name (Legal Business Name): KATHRYN CONTI ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3104 LORD BALTIMORE DR SUITE 100
BALTIMORE MD
21244-2898
US

IV. Provider business mailing address

10224 TUSCANY RD
ELLICOTT CITY MD
21042-2100
US

V. Phone/Fax

Practice location:
  • Phone: 410-298-0990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: