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General NPI Number Information
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NPI Number | 1134544976
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Entity Type | Individual
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Provider Name | ANNE BEETHE MA, LAT, CSCS
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Gender | Female
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 100 BELMONT MOUNT HOLLY RD
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City | BELMONT
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State | NC
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Zip | 28012-2702
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Country | US
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Telephone | 704-461-6215
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Fax | 704-461-6570
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Provider Business Mailing Address
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Address Line | 2571 CHERBOUGH WAY APT I
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City | GASTONIA
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State | NC
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Zip | 28056-5506
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Country | US
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Telephone | 970-420-4703
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2414
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License Number State | NC
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