Provider Demographics
NPI:1780637074
Name:FUNKHOUSER, BETH ALISON (MED, ATC, CSCS)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ALISON
Last Name:FUNKHOUSER
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Gender:F
Credentials:MED, ATC, CSCS
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Mailing Address - Street 1:PO BOX 947
Mailing Address - Street 2:EMORY & HENRY COLLEGE- KING ATHLETIC CENTER
Mailing Address - City:EMORY
Mailing Address - State:VA
Mailing Address - Zip Code:24327
Mailing Address - Country:US
Mailing Address - Phone:276-698-7530
Mailing Address - Fax:
Practice Address - Street 1:12228 ITTA BENA DR
Practice Address - Street 2:EMORY & HENRY COLLEGE- KING ATHLETIC CENTER
Practice Address - City:EMORY
Practice Address - State:VA
Practice Address - Zip Code:24327
Practice Address - Country:US
Practice Address - Phone:276-944-6590
Practice Address - Fax:276-944-6738
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2013-01-15
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Provider Licenses
StateLicense IDTaxonomies
VA01260004372255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer