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NPI 1780072124

NPI 1780072124 : ERIC ENGLISH ATC : SPARTANBURG, SC

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General NPI Number Information
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    NPI Number           |    1780072124
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC ENGLISH ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/08/2015
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    Last Update Date     |    01/08/2015
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Provider Practice Location Address
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    Address Line         |    800 UNIVERSITY WAY 
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    City                 |    SPARTANBURG
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    State                |    SC
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    Zip                  |    29303-4932
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    Country              |    US
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    Telephone            |    864-503-5015
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    Fax                  |    864-503-5130
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Provider Business Mailing Address
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    Address Line         |    301 TARRIGART DR 
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    City                 |    MOORE
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    State                |    SC
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    Zip                  |    29369-9158
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    Country              |    US
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    Telephone            |    864-574-0914
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    Fax                  |    864-503-5130
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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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