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General NPI Number Information
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NPI Number | 1720277908
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Entity Type | Individual
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Provider Name | ANDREW OSIKA ATC
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Gender | Male
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 3751 BLUE HERON DR
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City | GULF SHORES
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State | AL
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Zip | 36542-2787
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Country | US
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Telephone | 251-981-4408
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Fax | 251-217-9304
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Provider Business Mailing Address
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Address Line | PO BOX 2008
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City | ORANGE BEACH
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State | AL
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Zip | 36561-2008
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Country | US
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Telephone | 251-981-4408
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Fax | 251-217-9304
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | IL
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