Jeffrey Alan Coulter, MS, ATC

Individual provider Active NPI Athletic Trainer · Newberry, SC

NPI 1780936732 · NPPES record last updated Jan 30, 2015

Key facts

NPI
1780936732
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1398 (SC)
Practice address
2100 College St
Newberry, SC 29108-2126
Phone
(803) 321-5184
Fax
(800) 882-9648
NPI assigned
Oct 15, 2012
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
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1398 SC Yes

Addresses

Primary practice location

2100 College St
Newberry, SC 29108-2126

Mailing address

100 Walden Heights Dr
Apt 513
Irmo, SC 29063-7865
Phone (803) 673-9498

Other providers in Newberry, SC

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

Sources for this page

Verify at the official NPI Registry.