Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | PTH8094 | AL |
Y | 213ES0000X | Sports Medicine | PTH8094 | AL |
NPI | 1386079739 |
---|---|
Provider Name | Dr. Thomas Daniel Eck |
First Address | Rogersville, AL 35652-0869 |
Second Address | Rogersville, AL 35652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2013 |
Last Update Date | 21/09/2016 |