MEDICARE: MR. STEVEN B PURCELL MS, AT

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	AT.003731	OH

General Provider Information

NPI Number	:	1205086709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN B PURCELL MS, AT

Provider Business Mailing Address
First Line	:	1695 WESSEL DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-4313
Country	:	US
Telephone Number	:	314-805-8117
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BLACK AND GOLD BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2091
Country	:	US
Telephone Number	:	314-805-8117
Fax Number	:

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

Provider Enumeration Date	:	09/22/2008
Last Update Date	:	03/06/2013

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