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General NPI Number Information
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NPI Number | 1063441483
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Entity Type | Individual
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Provider Name | ERIK THOMAS NASON MBA, MS, ATC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 770 W GRANADA BLVD
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City | ORMOND BEACH
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State | FL
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Zip | 32174
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Country | US
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Telephone | 321-537-2633
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Fax |
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Provider Business Mailing Address
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Address Line | 2910 JACARANDA TRL
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City | TITUSVILLE
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State | FL
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Zip | 32780-5997
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Country | US
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Telephone | 321-264-2966
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Fax |
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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 | AL820
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License Number State | FL
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