MEDICARE: AARON KREJCI

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	074477	IA

General Provider Information

NPI Number	:	1063873693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON KREJCI

Provider Business Mailing Address
First Line	:	459 4TH ST SW
Second Line	:
City	:	BLOOMING PRAIRIE
State	:	MN
Zip	:	55917-1364
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1227 W 27TH ST
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50614-0012
Country	:	US
Telephone Number	:	507-440-6958
Fax Number	:

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

Provider Enumeration Date	:	03/09/2016
Last Update Date	:	03/09/2016

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