Provider Demographics
NPI:1336625722
Name:JUNKINS, ROY CHRISTOPHER (L/ATC, MS, PTA)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:CHRISTOPHER
Last Name:JUNKINS
Suffix:
Gender:M
Credentials:L/ATC, MS, PTA
Other - Prefix:
Other - First Name:ROY
Other - Middle Name:CHRISTOPHER
Other - Last Name:JUNKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:L/ATC, MS, PTA
Mailing Address - Street 1:319 COOPER LN
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-8211
Mailing Address - Country:US
Mailing Address - Phone:864-320-1915
Mailing Address - Fax:
Practice Address - Street 1:227 S PENDLETON ST STE B
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3047
Practice Address - Country:US
Practice Address - Phone:864-855-7030
Practice Address - Fax:864-855-7019
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer