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General NPI Number Information
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NPI Number | 1003404450
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Entity Type | Organization
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Legal Business Name | NORTH GREENVILLE UNIVERSITY
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Dates
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Enumeration Date | 12/31/2020
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Last Update Date | 12/31/2020
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Provider Practice Location Address
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Address Line | 7801 N TIGERVILLE RD
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City | TIGERVILLE
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State | SC
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Zip | 29688-9700
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Country | US
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Telephone | 864-867-4677
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Fax |
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Provider Business Mailing Address
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Address Line | 7801 N TIGERVILLE RD
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City | TIGERVILLE
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State | SC
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Zip | 29688-9700
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Country | US
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Telephone | 864-867-4677
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF SPORTS MEDICINE
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Name | JAMES ANDERSON
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Credential | ATC
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Telephone | 864-867-4677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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