Provider Demographics
NPI:1861465148
Name:ATKINS, ALLEN KENT (ATC)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:KENT
Last Name:ATKINS
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 1:600 WATFORD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-2102
Mailing Address - Country:US
Mailing Address - Phone:864-229-5550
Mailing Address - Fax:864-388-8084
Practice Address - Street 1:320 STANLEY AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-2056
Practice Address - Country:US
Practice Address - Phone:864-388-8818
Practice Address - Fax:864-388-8084
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer