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General NPI Number Information
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NPI Number | 1215309687
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Entity Type | Organization
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Legal Business Name | PFEIFFER UNIVERSITY SPORTS MEDICINE
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 48380 US-52
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City | MISENHEIMER
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State | NC
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Zip | 28109
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Country | US
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Telephone | 704-473-3216
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Fax | 704-463-5051
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Provider Business Mailing Address
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Address Line | PO BOX 960 MERNER GYMNASIUM
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City | MISENHEIMER
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State | NC
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Zip | 28109
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Country | US
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Telephone | 704-473-3216
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Fax | 704-463-5051
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Authorized Official
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Title or Position | HEAD ATHLETIC TRAINER
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Name | MR. JOHN LEVITT
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Credential | LAT, ATC
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Telephone | 704-463-3216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 000020848
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License Number State | NJ
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