MEDICARE: MRS. CINDY LYNN DINKEL 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	0506094	NV

General Provider Information

NPI Number	:	1275599334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CINDY LYNN DINKEL ATC

Provider Business Mailing Address
First Line	:	10342 DENMAN ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-8031
Country	:	US
Telephone Number	:	702-810-6077
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 W ERIE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-7321
Country	:	US
Telephone Number	:	702-799-6881
Fax Number	:	702-799-2513

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	05/05/2014

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