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NPI Code Detail

MEDICARE: MR. TOBY WILLIAM HARKINS ATC

MEDICARE: MR. TOBY WILLIAM HARKINS ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer344SC

General Provider Information

NPI Number : 1568515815
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TOBY WILLIAM HARKINS ATC
Provider Business Mailing Address
First Line : 8548 CHLOE LN
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-8100
Country : US
Telephone Number : 843-863-7681
Fax Number : 843-863-7392
Provider Business Practice Location Address
First Line : 9200 UNIVERSITY BLVD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9121
Country : US
Telephone Number : 843-863-7681
Fax Number : 843-863-7392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 07/08/2007

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