Healthcare Provider Details

I. General information

NPI: 1194247122
Provider Name (Legal Business Name): ABBEY LEIGH KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 OAK LANE DR
CARLISLE PA
17015-8485
US

IV. Provider business mailing address

23 OAK LANE DR
CARLISLE PA
17015-8485
US

V. Phone/Fax

Practice location:
  • Phone: 717-479-1957
  • Fax:
Mailing address:
  • Phone: 717-479-1957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StatePA

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: