Provider Demographics
NPI:1518102466
Name:HILL, DAVID RANDALL (ATC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RANDALL
Last Name:HILL
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 1:2836 HENSLOWE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-2677
Mailing Address - Country:US
Mailing Address - Phone:919-738-1850
Mailing Address - Fax:
Practice Address - Street 1:2836 HENSLOWE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-2677
Practice Address - Country:US
Practice Address - Phone:919-738-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-06
Last Update Date:2008-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0146174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist