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Individual

MR. CLYDE DONALD HASTINGS III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
127 RAMSGATE DR, SHELBY, NC 28152-8509
(704) 473-4788
Mailing address
127 RAMSGATE DR, SHELBY, NC 28152-8509
(704) 473-4788

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-3590
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000020597
BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
01
LAT-3590
NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS
NC
Enumeration date
01/09/2018
Last updated
02/02/2018
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