Healthcare Provider Details

I. General information

NPI: 1740568054
Provider Name (Legal Business Name): ATHLETIC TRAINING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

872 OHIO PIKE
CINCINNATI OH
45263-0000
US

IV. Provider business mailing address

P.O. BOX 637444
CINCINNATI OH
45263-7444
US

V. Phone/Fax

Practice location:
  • Phone: 513-999-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW W SMITH
Title or Position: OWNER
Credential: ATC
Phone: 513-843-7632