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General NPI Number Information
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NPI Number | 1376435800
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Entity Type | Individual
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Provider Name | TRISTAN CATO ATC
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Gender |
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 150 BOBBY DODD WAY NW
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City | ATLANTA
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State | GA
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Zip | 30332-2500
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Country | US
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Telephone | 870-926-8537
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Fax |
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Provider Business Mailing Address
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Address Line | 150 BOBBY DODD WAY NW
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City | ATLANTA
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State | GA
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Zip | 30332-2500
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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 | 2000058241
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License Number State | AZ
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