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General NPI Number Information
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NPI Number | 1184824732
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Entity Type | Individual
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Provider Name | SUZANNE ALLAIN A.T.
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 3460 SUMMIT RIDGE PKWY
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City | DULUTH
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State | GA
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Zip | 30096-1622
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Country | US
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Telephone | 770-813-0087
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Fax | 770-813-9006
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Provider Business Mailing Address
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Address Line | 3460 SUMMIT RIDGE PKWY STE 103
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City | DULUTH
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State | GA
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Zip | 30096-1623
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Country | US
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Telephone | 770-813-0087
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Fax | 770-813-9006
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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 | AT001159
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License Number State | GA
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