Provider Demographics
NPI:1538496682
Name:POUNDS, JEFFREY (ATC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:POUNDS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 THISTLE LN
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4141
Mailing Address - Country:US
Mailing Address - Phone:843-756-5060
Mailing Address - Fax:
Practice Address - Street 1:107 TOM TROUT DR. WB 106
Practice Address - Street 2:COASTAL CAROLINA UNIVERSITY
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29528
Practice Address - Country:US
Practice Address - Phone:843-349-2725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer