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General NPI Number Information
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NPI Number | 1205086709
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Entity Type | Individual
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Provider Name | STEVEN B PURCELL MS, AT
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Gender | Male
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 03/06/2013
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Provider Practice Location Address
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Address Line | 1 BLACK AND GOLD BLVD
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City | COLUMBUS
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State | OH
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Zip | 43211-2091
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Country | US
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Telephone | 314-805-8117
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Fax |
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Provider Business Mailing Address
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Address Line | 1695 WESSEL DR
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City | COLUMBUS
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State | OH
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Zip | 43235-4313
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Country | US
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Telephone | 314-805-8117
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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 | AT.003731
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License Number State | OH
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