Kyle Barlow, ATC
Individual provider Active NPI Athletic Trainer · Cross, SC
NPI 1104201508 · NPPES record last updated Jul 27, 2015
Key facts
- NPI
- 1104201508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2000021616 (SC)
- Practice address
- 1293 Old Highway 6
Cross, SC 29436-3578 - Phone
- (843) 899-8900
- NPI assigned
- Jul 27, 2015
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2000021616 | SC | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000021616 | SC | Yes |
Addresses
Primary practice location
1293 Old Highway 6
Cross, SC 29436-3578
Mailing address
515 Flycatcher Dr
Goose Creek, SC 29445-7341
Phone (740) 370-8558
Other providers in Cross, SC
All providers in Cross, SC · Athletic Trainer in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.