Josiah Hagemann, LAT, ATC

Individual provider Active NPI Athletic Trainer · Mars Hill, NC

NPI 1265713622 · NPPES record last updated Aug 30, 2011

Key facts

NPI
1265713622
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1552 (NC)
Practice address
100 Athletic St
Mars Hill, NC 28754-9134
Phone
(828) 689-1266
Fax
(828) 689-1313
NPI assigned
Aug 30, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1552 NC Yes

Addresses

Primary practice location

100 Athletic St
Mars Hill, NC 28754-9134

Mailing address

100 Athletic St
PO Box 6668
Mars Hill, NC 28754-9134
Phone (828) 689-1266

Other providers in Mars Hill, NC

All providers in Mars Hill, NC · Athletic Trainer in North Carolina

Sources for this page

Verify at the official NPI Registry.