Healthcare Provider Details

I. General information

NPI: 1962034793
Provider Name (Legal Business Name): RASHARD HAMMONDS ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 VIKINGS CIR
EAGAN MN
55121-1000
US

IV. Provider business mailing address

2600 VIKINGS CIR
EAGAN MN
55121-1000
US

V. Phone/Fax

Practice location:
  • Phone: 561-876-8551
  • Fax:
Mailing address:
  • Phone: 561-876-8551
  • 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: