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NPI Code Detail

MEDICARE: TIFFANY FRANKLIN LAT, ATC

MEDICARE: TIFFANY FRANKLIN LAT, ATC
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 Trainer
22255A2300XAthletic Trainer36001393AIN

General Provider Information

NPI Number : 1750571378
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY FRANKLIN LAT, ATC
Provider Business Mailing Address
First Line : 2087 ACORN BLVD
Second Line :
City : FRANKLIN
State : IN
Zip : 46131-7306
Country : US
Telephone Number : 317-738-8001
Fax Number :
Provider Business Practice Location Address
First Line : 2087 ACORN BLVD
Second Line :
City : FRANKLIN
State : IN
Zip : 46131-7306
Country : US
Telephone Number : 317-738-8001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2007
Last Update Date : 09/03/2021

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Directions to “ TIFFANY FRANKLIN LAT, ATC” Practice Location

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