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NPI Code Detail

MEDICARE: CELIA LLOYD ATC/L

MEDICARE:   CELIA  LLOYD  ATC/L
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 Trainer428NM

General Provider Information

NPI Number : 1568917714
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELIA LLOYD ATC/L
Provider Business Mailing Address
First Line : 8005 LOUISIANA BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-5638
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8005 LOUISIANA BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-5638
Country : US
Telephone Number : 505-822-8868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2016
Last Update Date : 08/17/2016

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Directions to “ CELIA LLOYD ATC/L” Practice Location

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