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NPI Code Detail

MEDICARE: MISS CHRISTY MARIE HAWLEY ATC, LAT

MEDICARE: MISS CHRISTY MARIE HAWLEY ATC, LAT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer0613AZ

General Provider Information

NPI Number : 1255474888
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CHRISTY MARIE HAWLEY ATC, LAT
Provider Business Mailing Address
First Line : 625 S WESTWOOD UNIT 161
Second Line :
City : MESA
State : AZ
Zip : 85210-2246
Country : US
Telephone Number : 704-662-4391
Fax Number :
Provider Business Practice Location Address
First Line : 3300 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-3030
Country : US
Telephone Number : 602-639-6038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2007
Last Update Date : 07/08/2007

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