Individual
STEVEN SILVERSPARRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, SCAT, ATC
Contact information
Practice address
935 ONE LANDON LOOP, CONWAY, SC 29526
(843) 349-2768
Mailing address
PO BOX 261954, CONWAY, SC 29528-6054
(843) 349-2768
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1624
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1624
DHEC
SC
01
—
62103
NATA
SC
01
—
BOC266201
BOC
SC
Enumeration date
08/03/2016
Last updated
08/03/2016
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