Individual
MR. JAMES W. BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, NREMT
Contact information
Practice address
2301 CHURCH STREET, CONWAY HIGH SCHOOL, CONWAY, SC 29526
(843) 488-6191
Mailing address
4291 SUMMIT TRL, MYRTLE BEACH, SC 29579-6938
(843) 340-6411
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
18106
SC
2255A2300X
Athletic Trainer
Primary
070
SC
Other
Enumeration date
08/30/2005
Last updated
01/18/2023
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