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General NPI Number Information
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NPI Number | 1659836856
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Entity Type | Individual
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Provider Name | PAIGE ALEXANDRA MCHENRY LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 560 DEVALL DR STE 302
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City | AUBURN
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State | AL
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Zip | 36832-6660
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Country | US
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Telephone | 334-844-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 S FOX RUN PKWY APT 231
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City | OPELIKA
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State | AL
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Zip | 36801-5978
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Country | US
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Telephone | 215-499-7062
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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 | 2134
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License Number State | AL
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