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Individual

MS. DAWN YVONNE ANTHONY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
748 STANFIELD DR, CHARLOTTE, NC 28210-2816
(724) 859-2536
Mailing address
748 STANFIELD DR, CHARLOTTE, NC 28210-2816
(724) 859-2536

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1500
NC
2255A2300X
Athletic Trainer
RT003719
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020502121
NATA CERTIFICATION NUMBER
PA
01
1500
NC LICENSE
NC
01
RT003719
PA STATE LICENSE NUMBER
PA
Enumeration date
10/18/2006
Last updated
01/20/2012
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