Provider Demographics
NPI:1093139149
Name:OATES, DAVID CRAIG II (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CRAIG
Last Name:OATES
Suffix:II
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 TRUE ST APT 218
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-1747
Mailing Address - Country:US
Mailing Address - Phone:919-770-5528
Mailing Address - Fax:
Practice Address - Street 1:1051 BLOSSOM ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-0010
Practice Address - Country:US
Practice Address - Phone:803-777-0164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5202012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC22OtherRESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS