Healthcare Provider Details

I. General information

NPI: 1285035279
Provider Name (Legal Business Name): RICK SIGLER ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W MAUMEE ST STE 125
ADRIAN MI
49221-1397
US

IV. Provider business mailing address

556 MAITLAND DR
HORTON MI
49246-9010
US

V. Phone/Fax

Practice location:
  • Phone: 517-264-6141
  • Fax:
Mailing address:
  • Phone: 517-748-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2601000640
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: