MEDICARE: MR. JOHN FENTON ZINK JR. A.T.,C.

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
1	2255A2300X	Athletic Trainer	154	SC

General Provider Information

NPI Number	:	1700820834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN FENTON ZINK JR. A.T.,C.

Provider Business Mailing Address
First Line	:	33 HACKNEY PONY LN
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-3509
Country	:	US
Telephone Number	:	843-298-0595
Fax Number	:	843-757-2020

Provider Business Practice Location Address
First Line	:	39 HOSPITAL CENTER CMNS
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-2837
Country	:	US
Telephone Number	:	843-689-2234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	05/10/2024

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