Provider Demographics
NPI:1053524611
Name:WINTERS, ERIC ROSS (ATC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROSS
Last Name:WINTERS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4137 CANYON RD
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-9300
Mailing Address - Country:US
Mailing Address - Phone:740-522-2409
Mailing Address - Fax:740-587-5742
Practice Address - Street 1:200 LIVINGSTON WAY
Practice Address - Street 2:DENISON UNIVERSITY DEPARTMENT OF PHYSICAL EDUCATION
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023
Practice Address - Country:US
Practice Address - Phone:740-587-6311
Practice Address - Fax:740-587-5742
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0005472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer