Julie Ann Bamberg, ATC

Individual provider Active NPI Athletic Trainer · Charleston, SC

NPI 1144759689 · NPPES record last updated Jun 16, 2018

Key facts

NPI
1144759689
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1834 (SC)
Practice address
1906 Gammon St
Charleston, SC 29414-8129
Phone
(561) 389-2610
Fax
(561) 389-2610
NPI assigned
Jun 8, 2017
Sex
Female
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
1834SCMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1834 SC Yes

Addresses

Primary practice location

1906 Gammon St
Charleston, SC 29414-8129

Mailing address

1906 Gammon St
Charleston, SC 29414-8129
Phone (561) 389-2610

Other identifiers

IdentifierTypeStateIssuer
1834OtherSCHIGH SCHOOL SPORTS COVERAGE

Other providers in Charleston, SC

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

Sources for this page

Verify at the official NPI Registry.