Healthcare Provider Details

I. General information

NPI: 1831154335
Provider Name (Legal Business Name): DAVID EDWARD STRICKLAND ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 DONAGHEY AVE
CONWAY AR
72035-5001
US

IV. Provider business mailing address

1520 FREYALDENHOVEN LN
CONWAY AR
72032-4027
US

V. Phone/Fax

Practice location:
  • Phone: 501-450-5089
  • Fax:
Mailing address:
  • Phone: 501-450-0067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT191
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: