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General NPI Number Information
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NPI Number | 1295728947
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Entity Type | Individual
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Provider Name | CHRISTOPHER JAMES MARCUS ATC, SCAT
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Gender | Male
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Dates
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Enumeration Date | 08/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 JORDANVILLE RD
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City | AYNOR
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State | SC
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Zip | 29511-3601
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Country | US
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Telephone | 843-358-5114
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Fax | 843-358-7401
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Provider Business Mailing Address
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Address Line | 4977 MURRAY JOHNSON RD
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City | CONWAY
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State | SC
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Zip | 29526-4767
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Country | US
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Telephone | 843-365-5138
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Fax | 843-358-7401
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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 | 413
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License Number State | SC
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