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NPI Code Detail

MEDICARE: NICOLE L SCHREIBER ATC

MEDICARE: NICOLE L SCHREIBER 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 Trainer

General Provider Information

NPI Number : 1205852621
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE L SCHREIBER ATC
Provider Business Mailing Address
First Line : 14705 JACKSON ST
Second Line :
City : TAYLOR
State : MI
Zip : 48180-4746
Country : US
Telephone Number : 651-334-9694
Fax Number :
Provider Business Practice Location Address
First Line : 6525 2ND AVE
Second Line :
City : DETROIT
State : MI
Zip : 48202-3006
Country : US
Telephone Number : 313-972-1687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 04/01/2014

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Directions to “ NICOLE L SCHREIBER ATC” Practice Location

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