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General NPI Number Information
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NPI Number | 1669926952
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Entity Type | Individual
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Provider Name | EMILY FRANCES TESON ATC
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Gender | Female
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 7425 OLD MAIN HL
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City | LOGAN
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State | UT
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Zip | 84322-7425
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Country | US
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Telephone | 435-797-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 9319 ROBERT D SNYDER ROAD SUITE 416
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City | CHARLOTTE
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State | NC
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Zip | 28223-0001
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Country | US
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Telephone |
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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-5296
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License Number State | NC
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