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General NPI Number Information
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NPI Number | 1982669230
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Entity Type | Individual
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Provider Name | RICK L FLATEAU MS, ATC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3795 MANSELL RD
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City | ALPHARETTA
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State | GA
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Zip | 30022-8247
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Country | US
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Telephone | 404-785-8570
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Fax |
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Provider Business Mailing Address
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Address Line | 1508 INDIAN WAY
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City | CUMMING
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State | GA
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Zip | 30040-3504
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Country | US
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Telephone | 678-770-4554
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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 | AT000649
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License Number State | GA
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