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General NPI Number Information
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NPI Number | 1376079574
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Entity Type | Individual
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Provider Name | AUSTIN EPPLEY ATC
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Gender | Male
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Dates
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Enumeration Date | 05/08/2017
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 2000 CLAYTON STATE BLVD
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City | MORROW
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State | GA
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Zip | 30260-7137
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Country | US
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Telephone | 740-819-8735
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Fax |
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Provider Business Mailing Address
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Address Line | 240 WILDWOOD DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-7137
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Country | US
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Telephone |
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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 | AT002991
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | AT002991
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License Number State | GA
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