MEDICARE: MR. PHILIP ANTHONY HILL 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	AT760	TN

General Provider Information

NPI Number	:	1316060544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PHILIP ANTHONY HILL ATC

Provider Business Mailing Address
First Line	:	202 E GRIZZARD ST
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-3673
Country	:	US
Telephone Number	:	931-224-6244
Fax Number	:

Provider Business Practice Location Address
First Line	:	183 HOSPITAL RD
Second Line	:	SUITE B
City	:	WINCHESTER
State	:	TN
Zip	:	37398-2470
Country	:	US
Telephone Number	:	931-968-1232
Fax Number	:	931-968-9869

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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