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NPI 1861451965

NPI 1861451965 : JAMES STRICEK ATHLETIC TRAINER : BROCKWAY, PA

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General NPI Number Information
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    NPI Number           |    1861451965
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES STRICEK ATHLETIC TRAINER
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/20/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1200 WOOD ST 
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    City                 |    BROCKWAY
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    State                |    PA
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    Zip                  |    15824-2118
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    Country              |    US
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    Telephone            |    814-265-8792
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    Fax                  |    814-265-1899
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Provider Business Mailing Address
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    Address Line         |    324 PARK AVENUE EXT 
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    City                 |    CURWENSVILLE
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    State                |    PA
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    Zip                  |    16833-1557
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    Country              |    US
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    Telephone            |    814-371-8056
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    Fax                  |    814-265-1899
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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       |    RT002371A
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    License Number State |    PA
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