Healthcare Provider Details

I. General information

NPI: 1447469846
Provider Name (Legal Business Name): TERESA M PRITCHETT A.T.,C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 06/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 E 1ST AVE
EASLEY SC
29640-3040
US

IV. Provider business mailing address

2911 TEAKWOOD DR
NASHVILLE TN
37214-3231
US

V. Phone/Fax

Practice location:
  • Phone: 864-850-2663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2301
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: