MEDICARE: MRS. ABIGAIL SANTEK ATC, LAT, MS

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	0506561	NV

General Provider Information

NPI Number	:	1841826864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ABIGAIL SANTEK ATC, LAT, MS

Provider Business Mailing Address
First Line	:	6775 EDMOND ST STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3502
Country	:	US
Telephone Number	:	269-303-1334
Fax Number	:

Provider Business Practice Location Address
First Line	:	6775 EDMOND ST STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3502
Country	:	US
Telephone Number	:	269-303-1334
Fax Number	:

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

Provider Enumeration Date	:	03/21/2020
Last Update Date	:	03/21/2020

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