Healthcare Provider Details

I. General information

NPI: 1437301223
Provider Name (Legal Business Name): TRICIA L SCHRAGE MS, ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2008
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 HUDSON RD HUMAN PERFORMANCE CENTER 003F
CEDAR FALLS IA
50614-0065
US

IV. Provider business mailing address

31035 BEAVER VALLEY ST
NEW HARTFORD IA
50660-8679
US

V. Phone/Fax

Practice location:
  • Phone: 319-273-7493
  • Fax: 319-273-7023
Mailing address:
  • Phone: 319-404-1109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number00463
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: