Provider Demographics
NPI:1881080034
Name:LENGAS, ERIC JENSEN (ATC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JENSEN
Last Name:LENGAS
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 1:100 CAMPUS DR
Mailing Address - Street 2:ELON UNIVERSITY ATHLETICS, 2500 C.B.
Mailing Address - City:ELON
Mailing Address - State:NC
Mailing Address - Zip Code:27244-9423
Mailing Address - Country:US
Mailing Address - Phone:336-471-0298
Mailing Address - Fax:
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:ELON UNIVERSITY ATHLETICS, 2500 C.B.
Practice Address - City:ELON
Practice Address - State:NC
Practice Address - Zip Code:27244-9423
Practice Address - Country:US
Practice Address - Phone:336-471-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-17962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer