MEDICARE: DR. AARON B TERRANOVA ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	1111	NC

General Provider Information

NPI Number	:	1033242110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON B TERRANOVA ATC

Provider Business Mailing Address
First Line	:	106 TATUM PLACE
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-3245
Country	:	US
Telephone Number	:	336-334-3563
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 WALKER AVE
Second Line	:	237 B HHP BLDG UNCG
City	:	GREENSBORO
State	:	NC
Zip	:	27403-3245
Country	:	US
Telephone Number	:	336-334-5925
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	06/05/2013

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