Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NICKLAS LIDSTROM
Active Sole ProprietorNICKLAS LIDSTROM is a Athletic Trainer healthcare provider located in CONWAY, South Carolina. NPI 1871369603 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · CONWAY, SC
Registration Details
- NPI Number
- 1871369603
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 4, 2023 (2.5504214716963 yrs)
- Last Updated
- Dec 4, 2023
- License
-
AT03472 (SC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
925 ONE LANDON LOOPCONWAY, SC, 29528Browse SC providers · Browse ZIP 29528
- Phone
- 8433492825
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in CONWAY, SC
| Name | Credential | NPI |
|---|---|---|
| MR. JAMES W. BERRY | ATC, NREMT | 1235122789 |
| DWAYNE MICHAEL BEAM | ATC | 1972602266 |
| JEFFREY POUNDS | ATC | 1538496682 |
| MISS ANDRESSA OLIVEIRA MARTINS | ATC | 1376806786 |
| RACHEL LEANNE SHARPE | ATC, LAT | 1124382619 |
| KAITLIN COYNE | ATC | 1699137927 |
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.