| Organization Name: | ATHLETIC MEDICAL SOLUTIONS EAST, LLC |
| NPI Number: | 1649607318 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KARLA TALLEDO (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 4261 Kimberly Pkwy Columbus |
| State: | OH US |
| Postal Code: | 432327226 |
| Phone Number: | 6147557700 |
| Fax Number: | 6147559634 |
| NPI Enumeration Date: | 09/26/2013 |
| NPI Last Update Date: | 09/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |