Healthcare Provider Details

I. General information

NPI: 1336625722
Provider Name (Legal Business Name): ROY CHRISTOPHER JUNKINS L/ATC, MS, PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROY CHRISTOPHER JUNKINS L/ATC, MS, PTA

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 S PENDLETON ST STE B
EASLEY SC
29640-3047
US

IV. Provider business mailing address

319 COOPER LN
EASLEY SC
29642-8211
US

V. Phone/Fax

Practice location:
  • Phone: 864-855-7030
  • Fax: 864-855-7019
Mailing address:
  • Phone: 864-320-1915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number387
License Number StateSC

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: