Blake Banner
NPI #1821465592 in Elgin, South Carolina
Provider Information
- NPI Number
- 1821465592
- Entity Type
- Individual
- Name
- Blake Banner
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- Aug 28, 2015
- Last Updated
- Aug 28, 2015
Practice Location
- Address
- 971A ROBERTS DR
- City
- Elgin
- State
- South Carolina
- ZIP Code
- 29045-9087
- Phone
- (803) 543-2185
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
| Student in an Organized Health Care Education/Training Program |
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