Lance David Markham, ATC, CSCS

Individual provider Active NPI Athletic Trainer · Young Harris, GA

NPI 1487783684 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487783684
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
AT000805 (GA)
Practice address
37 College St
Young Harris, GA 30582
Phone
(706) 379-5199
Fax
(706) 379-4593
NPI assigned
Mar 5, 2007
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
AT000805GAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT000805 GA Yes

Addresses

Primary practice location

37 College St
Young Harris, GA 30582

Mailing address

7493 Hooper CV
Young Harris, GA 30582-2017
Phone (706) 379-9619

Other providers in Young Harris, GA

All providers in Young Harris, GA · Athletic Trainer in Georgia

Sources for this page

Verify at the official NPI Registry.