MEDICARE: MR. CHAD C ABRAMS 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	284	AL

General Provider Information

NPI Number	:	1144265984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHAD C ABRAMS ATC

Provider Business Mailing Address
First Line	:	512 WEBSTER FORD RD
Second Line	:
City	:	TALLASSEE
State	:	AL
Zip	:	36078-3147
Country	:	US
Telephone Number	:	334-257-4499
Fax Number	:

Provider Business Practice Location Address
First Line	:	1199 S DONAHUE DR STE C
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36832-5805
Country	:	US
Telephone Number	:	334-821-2733
Fax Number	:

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	09/11/2008

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