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General NPI Number Information
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NPI Number | 1891364485
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Entity Type | Individual
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Provider Name | KAITLIN MARIE HAILEY ATC/ LAT
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Gender | Female
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 433 WILSON RD
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City | GRIFFIN
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State | GA
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Zip | 30224-4547
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Country | US
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Telephone | 770-229-3775
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Fax |
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Provider Business Mailing Address
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Address Line | 516 S 6TH ST STE A
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City | GRIFFIN
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State | GA
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Zip | 30224-4322
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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 | AT004442
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License Number State | GA
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