Provider Demographics
NPI:1275760753
Name:DAY, ERIC RANDELL (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:RANDELL
Last Name:DAY
Suffix:
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 1:234 LONE TREE
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-8874
Mailing Address - Country:US
Mailing Address - Phone:830-331-9144
Mailing Address - Fax:
Practice Address - Street 1:234 LONE TREE
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-8874
Practice Address - Country:US
Practice Address - Phone:830-331-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT14602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer