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General NPI Number Information
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NPI Number | 1447760020
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Entity Type | Individual
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Provider Name | LATOYA HAMBRIDGE LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 03/18/2023
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Provider Practice Location Address
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Address Line | 11221 GALLERIA AVE STE 101
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City | RALEIGH
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State | NC
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Zip | 27614-8137
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Country | US
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Telephone | 919-562-9410
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Fax | 919-562-9425
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Provider Business Mailing Address
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Address Line | 100 CORSAIR DR
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City | MORRISVILLE
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State | NC
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Zip | 27560-5714
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Country | US
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Telephone | 919-824-2112
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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 |
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License Number State | NC
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