Provider Demographics
NPI:1811923964
Name:EUTEN, JOSHUA GREGORY (ATC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:GREGORY
Last Name:EUTEN
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 1:70 SKI COVE LN
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-0512
Mailing Address - Country:US
Mailing Address - Phone:843-861-9529
Mailing Address - Fax:
Practice Address - Street 1:1304 W. BOBO NEWSOME HWY
Practice Address - Street 2:CAROLINA PINES REGIONAL MEDICAL CENTER
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550
Practice Address - Country:US
Practice Address - Phone:843-861-9529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer