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General NPI Number Information
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NPI Number | 1649791807
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Entity Type | Individual
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Provider Name | HOPE WHITE LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 118 E SOUTH ST
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City | RALEIGH
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State | NC
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Zip | 27601-2341
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Country | US
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Telephone | 919-828-1730
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Fax |
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Provider Business Mailing Address
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Address Line | 133 LITTLE BAY DR
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City | CEDAR POINT
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State | NC
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Zip | 28584-7800
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Country | US
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Telephone | 919-608-5798
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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 | LAT-3071
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License Number State | NC
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