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General NPI Number Information
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NPI Number | 1588865000
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Entity Type | Individual
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Provider Name | BETSY J BUMBARGER ATC L
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5130 NW CABARRUS DR
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City | CONCORD
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State | NC
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Zip | 28027-7624
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Country | US
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Telephone | 704-788-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 1424 RAY SUGGS PL
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City | CONCORD
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State | NC
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Zip | 28027-4310
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Country | US
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Telephone | 704-786-0384
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1340
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License Number State | NC
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