Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARK EDWARD BOULDEN JR., ATC
ActiveMARK EDWARD BOULDEN JR., ATC is a Athletic Trainer healthcare provider located in GEORGETOWN, South Carolina. NPI 1053764977 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · GEORGETOWN, SC
Registration Details
- NPI Number
- 1053764977
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 15, 2016 (9.8931687468143 yrs)
- Last Updated
- Jul 15, 2016
- License
-
1667 (SC)
Practice Information
- Address
-
2185 N FRASER STGEORGETOWN, SC, 294406418Browse SC providers · Browse ZIP 29440
- Phone
- 8435271800
- Fax
- 8435276528
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in GEORGETOWN, SC
| Name | Credential | NPI |
|---|---|---|
| CHRISTOPHER DEVAULT | — | 1700293081 |
| MICHAELA TERESA ETHERIDGE | ATC | 1619502390 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.