# AASU SPORTS MEDICNE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215239934
- **Authorized official:** MS. LYDIA WILLIAMS ATC (HEAD ATHLETIC TRAINER)
- **Authorized official phone:** (912) 414-0271

## Contact information

- **Practice address:** 11935 ABERCORN ST, SAVANNAH, GA 31419-1909
- **Practice address phone:** (912) 344-2866
- **Practice address fax:** (912) 344-3420
- **Mailing address:** 11935 ABERCORN ST, SAVANNAH, GA 31419-1909
- **Mailing address phone:** (912) 344-2866
- **Mailing address fax:** (912) 344-3420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/01/2010
- **Last updated:** 12/01/2010