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General NPI Number Information
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NPI Number | 1851946636
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Entity Type | Individual
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Provider Name | HANNAH PRINCE LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 7336 RAGING RIDGE RD
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City | HARRISBURG
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State | NC
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Zip | 28075-7645
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Country | US
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Telephone | 704-260-6490
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Fax |
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Provider Business Mailing Address
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Address Line | 5116 SOARING EAGLE LN
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City | MINT HILL
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State | NC
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Zip | 28227-8166
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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-4286
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License Number State | NC
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