Healthcare Provider Details

I. General information

NPI: 1548312820
Provider Name (Legal Business Name): ERIN R COVEY MS, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLACK HILLS STATE UNIVERSITY 1200 UNIVERSITY UNIT 9403
SPEARFISH SD
57799-9403
US

IV. Provider business mailing address

BLACK HILLS STATE UNIVERSITY 1200 UNIVERSITY UNIT 9403
SPEARFISH SD
57799-9403
US

V. Phone/Fax

Practice location:
  • Phone: 605-642-6622
  • Fax: 605-642-6539
Mailing address:
  • Phone: 605-642-6622
  • Fax: 605-642-6539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number0199
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: