Healthcare Provider Details

I. General information

NPI: 1609831601
Provider Name (Legal Business Name): TORRIE A CHIZEK ATC, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: TORRIE A BJELLAND ATC, CSCS

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 4TH ST SW
MASON CITY IA
50401-2800
US

IV. Provider business mailing address

2055 MAPLE AVE
BRITT IA
50423-8577
US

V. Phone/Fax

Practice location:
  • Phone: 641-430-3047
  • Fax:
Mailing address:
  • Phone: 641-843-3650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number00470
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: