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NPI Code Detail

MEDICARE: REBECCA L MOKRIS D.ED., LAT

MEDICARE: REBECCA L MOKRIS D.ED., LAT
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 TrainerRT003516PA

General Provider Information

NPI Number : 1831270776
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA L MOKRIS D.ED., LAT
Provider Business Mailing Address
First Line : 503 W ARLINGTON RD
Second Line :
City : ERIE
State : PA
Zip : 16509-2205
Country : US
Telephone Number : 814-434-7933
Fax Number :
Provider Business Practice Location Address
First Line : 109 UNIVERSITY SQ
Second Line : MOROSKY COLLEGE OF HEALTH PROFESSIONS AND COLLEGES M164
City : ERIE
State : PA
Zip : 16541-0001
Country : US
Telephone Number : 814-434-7933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 06/15/2014

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