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NPI Code Detail

MEDICARE: MACAULY DOWNING ATC

MEDICARE: MACAULY DOWNING 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
12255A2300XAthletic TrainerAT.0002093CO

General Provider Information

NPI Number : 1184230971
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACAULY DOWNING ATC
Provider Business Mailing Address
First Line : 2927 N INSTITUTE ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-6344
Country : US
Telephone Number : 719-210-9701
Fax Number :
Provider Business Practice Location Address
First Line : 2927 N INSTITUTE ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-6344
Country : US
Telephone Number : 719-210-9701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2020
Last Update Date : 09/17/2020

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