Provider Demographics
NPI:1235616525
Name:HUNTER, LANCE CRAIG (ATC)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:CRAIG
Last Name:HUNTER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SHADOW OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-6056
Mailing Address - Country:US
Mailing Address - Phone:501-772-4073
Mailing Address - Fax:
Practice Address - Street 1:133 SHADOW OAKS DR
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-6056
Practice Address - Country:US
Practice Address - Phone:501-772-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer