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NPI Code Detail

MEDICARE: MR. DAVID G. MCBAIN LAT, ATC, CAA

MEDICARE:  MR. DAVID G. MCBAIN  LAT, ATC, CAA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerRT-000627-APA

General Provider Information

NPI Number : 1063405645
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID G. MCBAIN LAT, ATC, CAA
Provider Business Mailing Address
First Line : 205 W ALLEGHENY RD
Second Line :
City : IMPERIAL
State : PA
Zip : 15126-9770
Country : US
Telephone Number : 724-695-5246
Fax Number : 724-695-1546
Provider Business Practice Location Address
First Line : 205 W ALLEGHENY RD
Second Line :
City : IMPERIAL
State : PA
Zip : 15126-9770
Country : US
Telephone Number : 724-695-5246
Fax Number : 724-695-1546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 12/19/2013

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Directions to “ MR. DAVID G. MCBAIN LAT, ATC, CAA” Practice Location

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