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General NPI Number Information
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NPI Number | 1578973731
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Entity Type | Individual
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Provider Name | WILLIAM WYATT LITTLE MA, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 04/28/2014
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 100 S FOREST HILLS SCHOOL RD
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City | MARSHVILLE
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State | NC
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Zip | 28103-9494
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Country | US
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Telephone | 704-296-3025
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Fax | 704-233-4003
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Provider Business Mailing Address
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Address Line | 900 CENTER PARK DR STE J
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City | CHARLOTTE
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State | NC
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Zip | 28217-2962
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Country | US
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Telephone | 704-863-4878
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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 | 1929
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License Number State | NC
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