Provider Demographics
NPI:1548395395
Name:SCHOFIELD, GARY EDWARD JR (ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:EDWARD
Last Name:SCHOFIELD
Suffix:JR
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 JACLYN CIR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-7562
Mailing Address - Country:US
Mailing Address - Phone:404-825-8730
Mailing Address - Fax:
Practice Address - Street 1:124 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4238
Practice Address - Country:US
Practice Address - Phone:770-233-1800
Practice Address - Fax:770-233-0005
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0003362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer