Individual
MR. GAGE NATHANIEL BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
110 HEISMAN ST, CLEMSON, SC 29634-0001
(864) 656-3453
Mailing address
1770 BOXWOOD FARM RD, AMHERST, VA 24521-4511
(434) 841-1917
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1787
SC
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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