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General NPI Number Information
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NPI Number | 1013061118
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Entity Type | Individual
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Provider Name | MARCUS WHITFIELD OSBORNE LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 810 FAIRGROVE CHURCH RD CVMC-CENTER FOR REHABILITATION
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City | HICKORY
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State | NC
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Zip | 28602-9617
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Country | US
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Telephone | 828-326-2272
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Fax | 828-322-6559
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Provider Business Mailing Address
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Address Line | 1129 WINDY HILL DR NW
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City | CONOVER
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State | NC
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Zip | 28613-9095
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Country | US
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Telephone | 828-326-2272
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Fax | 828-322-6559
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0733
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License Number State | NC
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