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General NPI Number Information
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NPI Number | 1689057861
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Entity Type | Individual
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Provider Name | JUSTIN ANDREW TATMAN ATC
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Gender | Male
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 4249 CENTURY FARMS TER
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City | ANTIOCH
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State | TN
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Zip | 37013-5199
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Country | US
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Telephone | 615-936-7846
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Fax |
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Provider Business Mailing Address
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Address Line | 1507 LEVANTE AVE MAX OROVITZ BUILDING 124
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City | CORAL GABLES
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State | FL
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Zip | 33146-2416
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Country | US
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Telephone | 305-284-6727
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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 | 2495
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License Number State | TN
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