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General NPI Number Information
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NPI Number | 1275087785
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Entity Type | Individual
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Provider Name | TROY ROYAL HULL MS, LAT, ATC, OTC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 2860 RONALD REAGAN BLVD
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City | CUMMING
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State | GA
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Zip | 30041-6287
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Country | US
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Telephone | 910-305-2589
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 ROSEMAN TRL
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City | CUMMING
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State | GA
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Zip | 30040-9343
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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 | AT003794
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 20-0605
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License Number State |
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