Healthcare Provider Details

I. General information

NPI: 1154748721
Provider Name (Legal Business Name): LUCRETIA SPRIGGS LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2014
Last Update Date: 03/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 BILTMORE AVE
ASHEVILLE NC
28801-4612
US

IV. Provider business mailing address

123 SPRINGSIDE RD
ASHEVILLE NC
28803-3323
US

V. Phone/Fax

Practice location:
  • Phone: 443-986-4986
  • Fax: 828-213-0848
Mailing address:
  • Phone: 443-986-4986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2252
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: