Healthcare Provider Details

I. General information

NPI: 1326788241
Provider Name (Legal Business Name): TYLER HOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S COLLEGE RD
WILMINGTON NC
28403-3201
US

IV. Provider business mailing address

2406 SALINGER CT APT 101
WILMINGTON NC
28412-7540
US

V. Phone/Fax

Practice location:
  • Phone: 910-962-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2693
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: