Thomas Allen

Individual provider Active NPI Athletic Trainer · Lexington, SC

NPI 1013387653 · NPPES record last updated Sep 25, 2015

Key facts

NPI
1013387653
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1878 (SC)
Practice address
104 Saluda Pointe Dr
Lexington, SC 29072-7295
Phone
(803) 227-8000
NPI assigned
Sep 25, 2015
Sex
Male
Sole proprietor
Yes

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
1878SCMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1878 SC Yes

Addresses

Primary practice location

104 Saluda Pointe Dr
Lexington, SC 29072-7295

Mailing address

350 Powell Rd
Columbia, SC 29203-9364
Phone (704) 223-1626

Other providers in Lexington, SC

All providers in Lexington, SC · Athletic Trainer in South Carolina

Sources for this page

Verify at the official NPI Registry.