Provider Demographics
NPI:1649666868
Name:LETCHFORD, ELIZABETH CAMPBELL (MS, ATC, EMT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CAMPBELL
Last Name:LETCHFORD
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Gender:F
Credentials:MS, ATC, EMT
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Mailing Address - Street 1:1530 GOUGH ST
Mailing Address - Street 2:APT 205
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5369
Mailing Address - Country:US
Mailing Address - Phone:415-416-5896
Mailing Address - Fax:
Practice Address - Street 1:1530 GOUGH ST
Practice Address - Street 2:APT 205
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5369
Practice Address - Country:US
Practice Address - Phone:415-416-5896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA20000040692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer