Madison Rose Lane
Individual provider Active NPI Athletic Trainer · Longs, SC
NPI 1831769629 · NPPES record last updated Jun 25, 2021
Key facts
- NPI
- 1831769629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 2221 Meadowood LN
Longs, SC 29568-6516 - Phone
- (843) 877-1801
- NPI assigned
- Jun 25, 2021
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
2221 Meadowood LN
Longs, SC 29568-6516
Mailing address
2221 Meadowood LN
Longs, SC 29568-6516
Phone (843) 877-1801
Other providers in Longs, SC
- Highway Health Services LLC
- Gwanda Hill
- Deandra Holloway
- Home Therapy Inc
- John S. Enloe IV, D.C., P.C.
- Devon Rachael Layton
- Ji Y Lee
- Sandra T Logan
- Stephanie Ward Matthews
- Sara Bertha-a McGrail
All providers in Longs, 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 Jun 25, 2021. 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.