Provider Demographics
NPI:1881337293
Name:PAYNE, ERIKA AMMONS (LAT, ATC)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:AMMONS
Last Name:PAYNE
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 1:92 MCFARLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-3348
Mailing Address - Country:US
Mailing Address - Phone:205-344-9161
Mailing Address - Fax:205-344-9256
Practice Address - Street 1:219 INDUSTRIAL PARK ST
Practice Address - Street 2:
Practice Address - City:GORDO
Practice Address - State:AL
Practice Address - Zip Code:35466-2068
Practice Address - Country:US
Practice Address - Phone:205-364-1003
Practice Address - Fax:205-364-1006
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty