MEDICARE: RICK SIGLER 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	2601000640	MI

General Provider Information

NPI Number	:	1285035279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICK SIGLER ATC

Provider Business Mailing Address
First Line	:	556 MAITLAND DR
Second Line	:
City	:	HORTON
State	:	MI
Zip	:	49246-9010
Country	:	US
Telephone Number	:	517-748-3030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 W MAUMEE ST STE 125
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-1397
Country	:	US
Telephone Number	:	517-264-6141
Fax Number	:

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

Provider Enumeration Date	:	09/09/2014
Last Update Date	:	09/09/2014

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