Mark Edward Boulden JR., ATC
NPI #1053764977 in Georgetown, South Carolina
Provider Information
- NPI Number
- 1053764977
- Entity Type
- Individual
- Name
- Mark Edward Boulden JR., ATC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Jul 15, 2016
- Last Updated
- Jul 15, 2016
Practice Location
- Address
- 2185 N FRASER ST
- City
- Georgetown
- State
- South Carolina
- ZIP Code
- 29440-6418
- Phone
- (843) 527-1800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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