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General NPI Number Information
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NPI Number | 1992307417
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Entity Type | Individual
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Provider Name | ANDREW HAIER ATC
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Gender | Male
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 1003 W SUNFLOWER RD # A3
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City | CLEVELAND
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State | MS
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Zip | 38733-0002
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Country | US
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Telephone | 315-617-2634
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 W SUNFLOWER RD # A3
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City | CLEVELAND
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State | MS
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Zip | 38733-0002
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Country | US
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Telephone | 315-617-2634
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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 | AT0896
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License Number State | MS
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