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NPI Code Detail

MEDICARE: SARAH ELIZABETH REILLY ATC

MEDICARE:   SARAH ELIZABETH REILLY  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 Trainer003957OH

General Provider Information

NPI Number : 1285071365
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ELIZABETH REILLY ATC
Provider Business Mailing Address
First Line : 2745 OBSERVATORY AVE
Second Line : APT 6
City : CINCINNATI
State : OH
Zip : 45208-2237
Country : US
Telephone Number : 513-304-2043
Fax Number :
Provider Business Practice Location Address
First Line : 2745 OBSERVATORY AVE
Second Line : APT 6
City : CINCINNATI
State : OH
Zip : 45208-2237
Country : US
Telephone Number : 513-304-2043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2013
Last Update Date : 05/29/2013

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Directions to “ SARAH ELIZABETH REILLY ATC” Practice Location

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