Grayson Hunter Elmore, ATC

Individual provider Active NPI Athletic Trainer · Clarksville, TN

NPI 1881997906 · NPPES record last updated Aug 7, 2015

Key facts

NPI
1881997906
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
0000001433 (TN)
Practice address
2231 Madison St Ste J
Clarksville, TN 37043-6182
Phone
(931) 245-2845
NPI assigned
Dec 11, 2010
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
0000001433TNMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0000001433 TN Yes

Addresses

Primary practice location

2231 Madison St Ste J
Clarksville, TN 37043-6182

Mailing address

2231 Madison St Ste J
Clarksville, TN 37043-6182
Phone (931) 245-2845

Other providers in Clarksville, TN

All providers in Clarksville, TN · Athletic Trainer in Tennessee

Sources for this page

Verify at the official NPI Registry.