MEDICARE: JEFFREY THOMAS WESTLING

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	ATR-009320	AZ

General Provider Information

NPI Number	:	1841858453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY THOMAS WESTLING

Provider Business Mailing Address
First Line	:	19822 N 33RD PL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-7909
Country	:	US
Telephone Number	:	602-448-9272
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 E RIVER RD STE 215
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-7645
Country	:	US
Telephone Number	:	602-448-9272
Fax Number	:

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

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	05/15/2025

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