Healthcare Provider Details

I. General information

NPI: 1902157399
Provider Name (Legal Business Name): ERIC ARMSTRONG ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 BILBY RD SUITE 201
HACKETTSTOWN NJ
07840-4174
US

IV. Provider business mailing address

808 FAULKNER DR
HACKETTSTOWN NJ
07840-1668
US

V. Phone/Fax

Practice location:
  • Phone: 908-684-3005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number25MT00141300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: