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NPI Code Detail

MEDICARE: MISS REH LYNN VANATTA

MEDICARE: MISS REH LYNN VANATTA
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 Trainer
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1942698642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS REH LYNN VANATTA
Provider Business Mailing Address
First Line : PO BOX 606
Second Line :
City : PONCHA SPRINGS
State : CO
Zip : 81242-0606
Country : US
Telephone Number : 719-207-1256
Fax Number :
Provider Business Practice Location Address
First Line : 1100 NORTH AVE
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81501-3122
Country : US
Telephone Number : 970-248-1635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2015
Last Update Date : 01/03/2015

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Directions to “ MISS REH LYNN VANATTA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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