Provider Demographics
NPI:1093170961
Name:DENISON, DAVID BRIAN JR (ATS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BRIAN
Last Name:DENISON
Suffix:JR
Gender:M
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 TUMBLEWEED DR
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-9360
Mailing Address - Country:US
Mailing Address - Phone:828-313-7615
Mailing Address - Fax:
Practice Address - Street 1:2805 TUMBLEWEED DR
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-9360
Practice Address - Country:US
Practice Address - Phone:828-313-7615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-20
Last Update Date:2015-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer