Provider Demographics
NPI:1164551313
Name:PRYOR, DAVID KEITH (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:KEITH
Last Name:PRYOR
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 1:137 S COUNTRY CLUB DR
Mailing Address - Street 2:UPSTAIRS
Mailing Address - City:CULLOWHEE
Mailing Address - State:NC
Mailing Address - Zip Code:28723-9514
Mailing Address - Country:US
Mailing Address - Phone:814-229-7024
Mailing Address - Fax:
Practice Address - Street 1:92 CATAMOUNT RD
Practice Address - Street 2:
Practice Address - City:CULLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723
Practice Address - Country:US
Practice Address - Phone:828-227-2044
Practice Address - Fax:828-227-7509
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer