Healthcare Provider Details

I. General information

NPI: 1689887754
Provider Name (Legal Business Name): CHAD ANDREW RANKIN MS, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 SPORTSMAN DR SUITE 10
CLARION PA
16214-8572
US

IV. Provider business mailing address

6175 OLEAN TRL
NEW BETHLEHEM PA
16242-5011
US

V. Phone/Fax

Practice location:
  • Phone: 814-226-1355
  • Fax: 814-226-1240
Mailing address:
  • Phone: 814-275-3168
  • Fax: 814-473-8201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT003416
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: