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General NPI Number Information
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NPI Number | 1255005187
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Entity Type | Individual
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Provider Name | CHRISTINE HOPE LATAINE DEAN PTA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 503 N FAYETTEVILLE ST
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City | ASHEBORO
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State | NC
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Zip | 27203-4728
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Country | US
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Telephone | 336-626-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 4836 LOG CABIN RD
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City | RAMSEUR
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State | NC
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Zip | 27316-8511
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Country | US
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Telephone | 336-964-9470
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A4731
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License Number State | NC
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