Healthcare Provider Details

I. General information

NPI: 1902289952
Provider Name (Legal Business Name): CAROL FAHRINGER MS, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL OSGOOD MS, LAT, ATC

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 10/22/2026
Certification Date: 10/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 CACTUS DR
GUYMON OK
73942-6003
US

IV. Provider business mailing address

PO BOX 34
GOODWELL OK
73939-0034
US

V. Phone/Fax

Practice location:
  • Phone: 316-323-9527
  • Fax:
Mailing address:
  • Phone: 316-323-9527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2000016005
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: