Brian J Blackburn, A.T., C.
Individual provider Active NPI Athletic Trainer · Lexington, SC
NPI 1649367152 · NPPES record last updated Oct 6, 2014
Key facts
- NPI
- 1649367152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 379 (SC)
- Practice address
- 104 Saluda Pointe Dr
Lexington, SC 29072-7295 - Phone
- (803) 413-0220
- NPI assigned
- Oct 6, 2006
- 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 |
|---|---|---|---|
| 379 | SC | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 379 | SC | Yes |
Addresses
Primary practice location
104 Saluda Pointe Dr
Lexington, SC 29072-7295
Mailing address
104 Saluda Pointe Dr
Lexington, SC 29072-7295
Phone (803) 413-0220
Other providers in Lexington, SC
- Bio-Medical Applications of South Carolina, Inc.
- Carolyn Birchmore
- Jeremy Bishop
- Paul Bishop
- Janice D Black
- Ashlee Blackwelder
- Jessica Blackwell
- Madonna Morgan Blair
- Sommer Cagle Blair
- Thomas T Blake Jr.
All providers in Lexington, 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 Oct 6, 2014. 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.