Provider Demographics
NPI:1770865974
Name:ADVANCED ATHLETIC TRAINING SOLUTIONS
Entity Type:Organization
Organization Name:ADVANCED ATHLETIC TRAINING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CERTIFIED ATHELTIC TRAINER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:SHIRK
Authorized Official - Last Name:SNEED
Authorized Official - Suffix:
Authorized Official - Credentials:ATC, LAT
Authorized Official - Phone:704-968-2217
Mailing Address - Street 1:856 REBECCA JANE DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-8225
Mailing Address - Country:US
Mailing Address - Phone:704-968-2217
Mailing Address - Fax:704-663-5197
Practice Address - Street 1:111 KILSON DR
Practice Address - Street 2:104
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8217
Practice Address - Country:US
Practice Address - Phone:704-968-2217
Practice Address - Fax:704-663-5197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy