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General NPI Number Information
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NPI Number | 1205938545
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Entity Type | Individual
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Provider Name | JEFFERY T HAMER ATC, LAT, CSCS
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 RAM WAY
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City | SARASOTA
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State | FL
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Zip | 34231-5141
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Country | US
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Telephone | 941-232-3944
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Fax |
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Provider Business Mailing Address
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Address Line | 4073 ARDMORE LN
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City | SARASOTA
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State | FL
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Zip | 34232-5030
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Country | US
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Telephone | 941-232-3944
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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 | 1493
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License Number State | FL
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