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General NPI Number Information
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NPI Number | 1538496682
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Entity Type | Individual
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Provider Name | JEFFREY POUNDS ATC
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Gender | Male
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Dates
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Enumeration Date | 11/11/2009
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Last Update Date | 11/11/2009
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Provider Practice Location Address
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Address Line | 107 TOM TROUT DR. WB 106 COASTAL CAROLINA UNIVERSITY
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City | CONWAY
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State | SC
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Zip | 29528
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Country | US
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Telephone | 843-349-2725
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Fax |
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Provider Business Mailing Address
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Address Line | 361 THISTLE LN
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-4141
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Country | US
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Telephone | 843-756-5060
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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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