MEDICARE: BAYLEE C REJCEK

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

General Provider Information

NPI Number	:	1538755970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAYLEE C REJCEK

Provider Business Mailing Address
First Line	:	410 N KERR ST
Second Line	:
City	:	BLOOMING GROVE
State	:	TX
Zip	:	76626-3390
Country	:	US
Telephone Number	:	903-602-9571
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 N KERR ST
Second Line	:
City	:	BLOOMING GROVE
State	:	TX
Zip	:	76626-3390
Country	:	US
Telephone Number	:	903-602-9571
Fax Number	:

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

Provider Enumeration Date	:	12/20/2020
Last Update Date	:	12/20/2020

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Directions to “ BAYLEE C REJCEK ” Practice Location

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