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General NPI Number Information
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NPI Number | 1841065240
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Entity Type | Individual
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Provider Name | KATHYRN PURDY
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Gender | Female
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 929 CHARLES ALLEN DR NE
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City | ATLANTA
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State | GA
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Zip | 30309-4204
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Country | US
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Telephone | 404-802-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 3498 SUMMERLIN PKWY
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-7811
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Country | US
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Telephone | 602-284-8099
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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 | AT002872
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License Number State | GA
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