Healthcare Provider Details

I. General information

NPI: 1437661725
Provider Name (Legal Business Name): WHITNEY JEAN BATCHELOR ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 10/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3992 CENTRAL CAMPUS DRIVE DEPT 3503
OGDEN UT
84408-0001
US

IV. Provider business mailing address

3992 CENTRAL CAMPUS DRIVE DEPT 3503
OGDEN UT
84408-3503
US

V. Phone/Fax

Practice location:
  • Phone: 801-626-6592
  • Fax: 801-626-8943
Mailing address:
  • Phone: 801-626-6592
  • Fax: 801-626-8943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number7957926-4810
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: