Provider Demographics
NPI:1609835321
Name:LANG, ERIC (MS, ATC, PTA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:LANG
Suffix:
Gender:M
Credentials:MS, ATC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 NORMAL AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2430
Mailing Address - Country:US
Mailing Address - Phone:541-488-0829
Mailing Address - Fax:
Practice Address - Street 1:686 NORMAL AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2430
Practice Address - Country:US
Practice Address - Phone:541-488-0829
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer