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General NPI Number Information
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NPI Number | 1992108922
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Entity Type | Individual
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Provider Name | JAMES DANIEL SCANLON ATC, NREMT
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Gender | Male
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Dates
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Enumeration Date | 10/05/2014
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Last Update Date | 10/05/2014
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Provider Practice Location Address
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Address Line | 24 PROVIDENCE RD
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City | GRAFTON
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State | MA
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Zip | 01519-1178
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Country | US
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Telephone | 508-839-5425
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Fax |
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Provider Business Mailing Address
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Address Line | 16 NORMAN LN
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City | DUDLEY
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State | MA
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Zip | 01571-5740
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Country | US
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Telephone |
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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 | 2589
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License Number State | MA
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