Healthcare Provider Details

I. General information

NPI: 1992273825
Provider Name (Legal Business Name): JOHN H FRANCE II ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 11/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 HITCHINS RD
GRAYSON KY
41143-1423
US

IV. Provider business mailing address

3701 BLACKBURN AVE
ASHLAND KY
41101-4945
US

V. Phone/Fax

Practice location:
  • Phone: 606-571-3023
  • Fax:
Mailing address:
  • Phone: 606-571-3023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT1479
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: