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General NPI Number Information
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NPI Number | 1801483128
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Entity Type | Individual
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Provider Name | ELIZABETH CORRIERE LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 2600 W NEAL ST
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City | COMMERCE
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State | TX
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Zip | 75428-4311
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Country | US
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Telephone | 940-200-1677
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 CENTER POINT LN APT 331
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City | GREENVILLE
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State | TX
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Zip | 75402-7740
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Country | US
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Telephone | 940-200-1677
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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 | 106668
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT9178
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License Number State | TX
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