Individual
SHIVAM GARG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 SILO CT APT 918B, COLUMBIA, SC 29201-4986
(508) 414-5634
Mailing address
112 SILO CT APT 918B, COLUMBIA, SC 29201-4986
(508) 414-5634
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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