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NPI 1760588131

NPI 1760588131 : KEVIN PILAND ATC : LAWRENCEVILLE, GA

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General NPI Number Information
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    NPI Number           |    1760588131
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    Entity Type          |    Individual 
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    Provider Name        |    KEVIN PILAND ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/15/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1455 PLEASANT HILL RD 501
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    City                 |    LAWRENCEVILLE
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    State                |    GA
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    Zip                  |    30044-3045
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    Country              |    US
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    Telephone            |    770-381-9226
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    Fax                  |    770-381-9277
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Provider Business Mailing Address
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    Address Line         |    1455 PLEASANT HILL RD 501
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    City                 |    LAWRENCEVILLE
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    State                |    GA
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    Zip                  |    30044-3045
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    Country              |    US
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    Telephone            |    770-381-9226
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    Fax                  |    770-381-9277
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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       |    000635
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    License Number State |    GA
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