Individual
LOGAN HATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, CPT
Contact information
Practice address
3 GRIER AVE, CHARLESTON, SC 29409-1004
(843) 953-6867
Mailing address
18525 ROLLINGDALE LN, DAVIDSON, NC 28036-7862
(704) 776-3781
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT03092
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000042328
BOC CERTIFICATION
—
01
—
AT03092
SOUTH CAROLINA ATHLETIC TRAINING LICENSURE
SC
Enumeration date
03/05/2019
Last updated
08/25/2021
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