=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588546816
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL C ROHAN ATC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2025
-----------------------------------------------------
Last Update Date | 07/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 BELMONT MOUNT HOLLY RD
-----------------------------------------------------
City | BELMONT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28012-2702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-204-8675
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 FERRELL AVE
-----------------------------------------------------
City | BELMONT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28012-3608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-204-8675
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number | LAT-5940
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------