Provider Demographics
NPI:1104844729
Name:HART, JOAN DELONG (MED, ATC, LAT)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:DELONG
Last Name:HART
Suffix:
Gender:F
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6461 FM 543
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7067
Mailing Address - Country:US
Mailing Address - Phone:214-535-7499
Mailing Address - Fax:972-837-2883
Practice Address - Street 1:6461 FM 543
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7067
Practice Address - Country:US
Practice Address - Phone:214-535-7499
Practice Address - Fax:972-837-2883
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT13482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer