George Johnnie Anderson, ATC

Individual provider Active NPI Athletic Trainer · Gallatin, TN

NPI 1003467523 · NPPES record last updated Sep 25, 2019

Key facts

NPI
1003467523
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
363 (TN)
Practice address
210 Preston LN
Gallatin, TN 37066-1499
Phone
(615) 604-3076
NPI assigned
Sep 25, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
363TNMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 363 TN Yes

Addresses

Primary practice location

210 Preston LN
Gallatin, TN 37066-1499

Mailing address

210 Preston LN
Gallatin, TN 37066-1499

Other providers in Gallatin, TN

All providers in Gallatin, TN · Athletic Trainer in Tennessee

Sources for this page

Verify at the official NPI Registry.