Individual
MR. SCOTT ANTHONY DECIANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
471 UNIVERSITY PARKWAY, USCA ATEP, AIKEN, SC 29801
(803) 641-3207
(803) 641-3723
Mailing address
3428 WESTMONT DR, AIKEN, SC 29801-2969
(803) 439-1677
(803) 641-3723
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
491
SC
Other
Enumeration date
08/07/2006
Last updated
07/08/2007
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