Individual
KEVIN JAY HEROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2 MEDICAL PARK RD STE 404, COLUMBIA, SC 29203-6875
(803) 434-8288
Mailing address
2 MEDICAL PARK RD STE 404, COLUMBIA, SC 29203-6875
(803) 434-8288
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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