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General NPI Number Information
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NPI Number | 1952363673
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Entity Type | Individual
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Provider Name | THOMAS M. MONAGAN JR. ATC
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Gender | Male
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 DONAGHEY DEPARTMENT OF ATHLETICS - UNIV OF CENTRAL ARKANSAS
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City | CONWAY
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State | AR
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Zip | 72034
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Country | US
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Telephone | 501-852-7749
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Fax | 501-450-5087
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Provider Business Mailing Address
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Address Line | 3430 IRBY DR. APT. 312
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City | CONWAY
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State | AR
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Zip | 72034-7313
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Country | US
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Telephone | 814-490-2757
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Fax | 501-450-5087
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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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