Provider Demographics
NPI:1194049650
Name:HARWARD, CRAIG ASHLEY (ATC)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:ASHLEY
Last Name:HARWARD
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 1:2799 MYRTLE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-9266
Mailing Address - Country:US
Mailing Address - Phone:803-534-1461
Mailing Address - Fax:
Practice Address - Street 1:S CAROLINA STATE UNIVERSITY
Practice Address - Street 2:300 COLLEGE STREET, N.E.
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29117-0001
Practice Address - Country:US
Practice Address - Phone:803-536-8625
Practice Address - Fax:803-533-3801
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer