Healthcare Provider Details

I. General information

NPI: 1265812036
Provider Name (Legal Business Name): ARIEL M ZALESKI ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 EMERGENCY ROOM DR CB#7470
CHAPEL HILL NC
27599-5035
US

IV. Provider business mailing address

320 EMERGENCY ROOM DR CB#7470
CHAPEL HILL NC
27599-5035
US

V. Phone/Fax

Practice location:
  • Phone: 607-316-8656
  • Fax:
Mailing address:
  • Phone: 607-316-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberLAT-2503
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: