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General NPI Number Information
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NPI Number | 1588010540
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Entity Type | Individual
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Provider Name | JAMES ANDERSON ATC
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Gender | Male
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 12/31/2020
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Provider Practice Location Address
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Address Line | 7801 N TIGERVILLE RD
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City | TIGERVILLE
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State | SC
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Zip | 29688-9700
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Country | US
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Telephone | 864-867-4677
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Fax |
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Provider Business Mailing Address
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Address Line | 4001 PELHAM RD APT 466
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City | GREER
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State | SC
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Zip | 29650-4380
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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 | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | BOC335022
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 2000027634
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License Number State | SC
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