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General NPI Number Information
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NPI Number | 1831645340
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL DUGAN ATC
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Gender | Male
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 5643 PLATT SPRINGS RD
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City | LEXINGTON
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State | SC
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Zip | 29073-9663
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Country | US
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Telephone | 843-364-0323
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Fax |
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Provider Business Mailing Address
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Address Line | 160 MESA VERDE DR
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City | LEXINGTON
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State | SC
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Zip | 29073-6893
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Country | US
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Telephone | 843-364-0323
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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 | SC520057
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License Number State | SC
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