Provider Demographics
NPI:1699805671
Name:GEIER, JEFFRY W (ATC,CSCS)
Entity type:Individual
Prefix:MR
First Name:JEFFRY
Middle Name:W
Last Name:GEIER
Suffix:
Gender:M
Credentials:ATC,CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ESD ATHLETICS
Mailing Address - Street 2:4100 MERRELL ROAD
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-6200
Mailing Address - Country:US
Mailing Address - Phone:214-353-5889
Mailing Address - Fax:214-353-5825
Practice Address - Street 1:ESD ATHLETICS
Practice Address - Street 2:4100 MERRELL ROAD
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-6200
Practice Address - Country:US
Practice Address - Phone:214-353-5889
Practice Address - Fax:214-353-5825
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT16412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer