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General NPI Number Information
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NPI Number | 1366713216
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Entity Type | Individual
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Provider Name | SCOTT DAMIAN HOAGLAND ATC,LAT,MS
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Gender | Male
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 268 S FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1435
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Country | US
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Telephone | 908-204-2585
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Fax |
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Provider Business Mailing Address
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Address Line | 162 KINGSBURY CT
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City | NAZARETH
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State | PA
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Zip | 18064-1121
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Country | US
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Telephone | 610-746-6468
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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 | 25MT00077500
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License Number State | NJ
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