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General NPI Number Information
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NPI Number | 1215698246
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Entity Type | Individual
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Provider Name | ERIN NICOLE LASWELL ATC
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Gender | Female
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Dates
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Enumeration Date | 01/03/2022
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 104 NORTON PARK DR APT 115
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City | WHITEHALL
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State | OH
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Zip | 43213-3562
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Country | US
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Telephone | 317-201-7588
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Fax |
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Provider Business Mailing Address
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Address Line | 100 W COLLEGE ST
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City | GRANVILLE
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State | OH
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Zip | 43023-1100
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Country | US
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Telephone | 317-201-7588
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT05999
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License Number State | OH
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