MEDICARE: MISS LYNN TOERGE ATC

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
1	2255A2300X	Athletic Trainer	RT000353A	PA

General Provider Information

NPI Number	:	1073641106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LYNN TOERGE ATC

Provider Business Mailing Address
First Line	:	203 MONROE DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15229-1214
Country	:	US
Telephone Number	:	412-367-0322
Fax Number	:

Provider Business Practice Location Address
First Line	:	2929 MCCULLY RD
Second Line	:
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-1327
Country	:	US
Telephone Number	:	412-486-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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