Individual provider · Type 1 NPI

Blake Banner

Student in an Organized Health Care Education/Training Program · Elgin, SC

NPI number 1821465592 Active

Practice location

971A Roberts Dr
Elgin, SC 29045-9087

Call (803) 543-2185 Map

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1821465592

Blake Banner's National Provider Identifier is 1821465592, issued on Aug 28, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Elgin, SC. The record was last updated on Aug 28, 2015.