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General NPI Number Information
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NPI Number | 1184363038
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Entity Type | Individual
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Provider Name | ANTHONY HARGROVE
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Gender | Male
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 650 HUGHES RD
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City | MADISON
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State | AL
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Zip | 35758-8737
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Country | US
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Telephone | 256-468-1410
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Fax |
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Provider Business Mailing Address
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Address Line | 240 KIRBY LN APT 1122
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City | MADISON
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State | AL
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Zip | 35757-6754
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Country | US
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Telephone |
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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 | 2925
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License Number State | AL
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