Provider Demographics
NPI:1821418781
Name:COMP, DAWN (MS, LAT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:COMP
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W. PIERCE ST. 128 KIRBY SPORTS CENTER
Mailing Address - Street 2:LAFAYETTE COLLEGE
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042
Mailing Address - Country:US
Mailing Address - Phone:610-330-5697
Mailing Address - Fax:610-330-5702
Practice Address - Street 1:700 WEST PIERCE 128 KIRBY SPORTS CENTER
Practice Address - Street 2:STREET LAFAYETTE COLLEGE
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042
Practice Address - Country:US
Practice Address - Phone:610-330-5697
Practice Address - Fax:610-330-5702
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001362A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer