Provider Demographics
NPI:1891934659
Name:HAYFORD, ELIZABETH (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HAYFORD
Suffix:
Gender:F
Credentials: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:PO BOX 7158
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28035-7158
Mailing Address - Country:US
Mailing Address - Phone:704-894-2774
Mailing Address - Fax:704-894-2802
Practice Address - Street 1:200 BAKER DRIVE
Practice Address - Street 2:BAKER SPORTS COMPLEX
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28035-7158
Practice Address - Country:US
Practice Address - Phone:704-894-2774
Practice Address - Fax:704-894-2802
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer