Provider Demographics
NPI:1124203492
Name:DINGMAN, ROXANNE M (ATC, OPA-C, SA-C)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:M
Last Name:DINGMAN
Suffix:
Gender:F
Credentials:ATC, OPA-C, SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E WOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3020
Mailing Address - Country:US
Mailing Address - Phone:864-560-4567
Mailing Address - Fax:864-560-4568
Practice Address - Street 1:303 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3020
Practice Address - Country:US
Practice Address - Phone:864-560-4567
Practice Address - Fax:864-560-4568
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
13-618246ZC0007X
1052246ZX2200X
SC5612255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant