Provider Demographics
NPI:1063011278
Name:KING, HILARY ANN (ATC)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:ANN
Last Name:KING
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2647 W EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-6116
Mailing Address - Country:US
Mailing Address - Phone:310-944-1857
Mailing Address - Fax:
Practice Address - Street 1:100 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-6058
Practice Address - Country:US
Practice Address - Phone:559-791-2640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20000098692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000009869OtherBOC FOR ATHLETIC TRAINERS