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General NPI Number Information
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NPI Number | 1457482952
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Entity Type | Organization
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Legal Business Name | ANDERSON UNIVERSITY
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 GEORGE B TIMMERMAN DR
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City | ANDERSON
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State | SC
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Zip | 29621-1802
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Country | US
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Telephone | 864-261-3658
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Fax |
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Provider Business Mailing Address
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Address Line | 316 BOULEVARD BOX 997
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City | ANDERSON
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State | SC
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Zip | 29621-4002
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Country | US
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Telephone | 864-231-2144
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Fax | 864-622-6059
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EVANS WHITAKER
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Credential |
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Telephone | 864-231-2100
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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 | 644
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License Number State | SC
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