Individual
NATHAN ORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
104 SALUDA POINTE DR, LEXINGTON, SC 29072-7295
(803) 296-9209
Mailing address
1013 E CEDAR RIDGE RD, SANDY, UT 84094-5608
(801) 599-1065
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175505958151
BLS PROVIDER
UT
01
—
2000036044
CERTIFIED ATHLETIC TRAINER
—
01
—
AT2630
DHEC
SC
Enumeration date
04/19/2019
Last updated
07/12/2021
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