Provider Demographics
NPI:1043609282
Name:ROUX, ERIC CHRISTOPHER (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:CHRISTOPHER
Last Name:ROUX
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 CHEROKEE BLVD
Mailing Address - Street 2:APT 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405
Mailing Address - Country:US
Mailing Address - Phone:201-317-5555
Mailing Address - Fax:
Practice Address - Street 1:615 MCCALLIE AVE # DEP3503
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2598
Practice Address - Country:US
Practice Address - Phone:201-317-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0009002255A2300X
TN27332255A2300X
NCLAT-24572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer