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General NPI Number Information
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NPI Number | 1952973588
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Entity Type | Individual
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Provider Name | DEREK LYNN HILL MAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 4656 N, AR-7 M
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City | HOT SPRINGS VILLAGE
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State | AR
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Zip | 71909-2502
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Country | US
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Telephone | 501-984-5575
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Fax |
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Provider Business Mailing Address
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Address Line | 397 LIBERTY HILL RD
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City | DIERKS
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State | AR
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Zip | 71833-9572
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Country | US
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Telephone | 870-784-5153
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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 |
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License Number State |
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