MEDICARE: JANET MILLIE LIN 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	AT002635	GA

General Provider Information

NPI Number	:	1285041210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET MILLIE LIN ATC

Provider Business Mailing Address
First Line	:	4343 WARM SPRINGS RD APT 102
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-5903
Country	:	US
Telephone Number	:	415-713-6932
Fax Number	:

Provider Business Practice Location Address
First Line	:	4343 WARM SPRINGS RD APT 102
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-5903
Country	:	US
Telephone Number	:	415-713-6932
Fax Number	:

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

Provider Enumeration Date	:	07/22/2014
Last Update Date	:	02/26/2016

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